This proposal is designed to provide the opportunity for the Principal Investigator (PI) to gain knowledge and skills in medical outcomes, economics and cost effectiveness evaluation under the supervision of an advisory committee comprising a highly qualified sponsor and co-investigators. The PI has exceptional clinical training and has completed a two-year fellowship in respiratory epidemiology at the Channing Laboratory. In addition she has obtained an M.S. in Clinical Epidemiology at the Harvard School of Public Health. This award in combination with the PI's background provides an excellent potential for development of a successful independent research career. The overall scientific goal of this proposal is to determine whether individuals with asthma management that conforms with recommendations published within the National Asthma Education and Prevention Program (NAEPP) Guidelines for the Diagnosis and Management of Asthma, results in an improved clinical outcome and is cost effective relative to individuals whose management does not conform. We propose to use the extensive information available on a cohort of adult and pediatric asthma patients assembled at Harvard Pilgrim Health Care (HPHC) in a retrospective cohort study design. We hypothesize that individuals with asthma pharmacotherapy and non- pharmacologic management (outpatient follow-up and specialist referral, asthma education, peak flow utilization, environmental measures) that conforms with the NAEPP Guidelines will have decreased health care utilization, improved Health Related Quality of Life (HRQL) and will be cost effective when compared with individuals whose management does not conform. This proposal is vital to the care of more than 14 million asthmatics in the United States. The NAEPP urges that evaluation of the guidelines be given """"""""high priority,"""""""" and that evaluation should consider not only evidence of efficacy but effectiveness, costs, and cost effectiveness of the therapeutic recommendations put forth.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Clinical Investigator Award (CIA) (K08)
Project #
5K08HL003919-05
Application #
6612716
Study Section
Special Emphasis Panel (ZHL1-CSR-Y (O1))
Program Officer
Rothgeb, Ann E
Project Start
1999-07-01
Project End
2005-06-30
Budget Start
2003-07-01
Budget End
2005-06-30
Support Year
5
Fiscal Year
2003
Total Cost
$133,920
Indirect Cost
Name
Brigham and Women's Hospital
Department
Type
DUNS #
030811269
City
Boston
State
MA
Country
United States
Zip Code
02115
Fuhlbrigge, Anne L; Carey, Vincent J; Finkelstein, Jonathan A et al. (2005) Validity of the HEDIS criteria to identify children with persistent asthma and sustained high utilization. Am J Manag Care 11:325-30
Celedon, J C; Fuhlbrigge, A; Rifas-Shiman, S et al. (2004) Antibiotic use in the first year of life and asthma in early childhood. Clin Exp Allergy 34:1011-6
Fuhlbrigge, Anne L (2004) Asthma severity and asthma control: symptoms, pulmonary function, and inflammatory markers. Curr Opin Pulm Med 10:1-6
Fuhlbrigge, Anne; Carey, Vincent J; Adams, Robert J et al. (2004) Evaluation of asthma prescription measures and health system performance based on emergency department utilization. Med Care 42:465-71
Fuhlbrigge, Anne L; Adams, Robert J (2003) The effect of treatment of allergic rhinitis on asthma morbidity, including emergency department visits. Curr Opin Allergy Clin Immunol 3:29-32
Gendo, Karna; Sullivan, Sean D; Lozano, Paula et al. (2003) Resource costs for asthma-related care among pediatric patients in managed care. Ann Allergy Asthma Immunol 91:251-7
Adams, Robert J; Weiss, Scott T; Fuhlbrigge, Anne (2003) How and by whom care is delivered influences anti-inflammatory use in asthma: Results of a national population survey. J Allergy Clin Immunol 112:445-50
Adams, Robert J; Fuhlbrigge, Anne; Guilbert, Theresa et al. (2002) Inadequate use of asthma medication in the United States: results of the asthma in America national population survey. J Allergy Clin Immunol 110:58-64
Adams, Robert J; Fuhlbrigge, Anne L; Finkelstein, Jonathan A et al. (2002) Intranasal steroids and the risk of emergency department visits for asthma. J Allergy Clin Immunol 109:636-42
Glauber, James H; Fuhlbrigge, Anne L (2002) Stratifying asthma populations by medication use: how you count counts. Ann Allergy Asthma Immunol 88:451-6

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