Asthma and CAM 2012 National Conference on Health Statistics Monitoring Health Care Reform through ProviderBased Surveys New Initiatives from the NAMCS amp NHAMCS August 8 2012 Anjali Talwalkar MD MPH ID: 908583
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NAMCS Special Supplements:Asthma and CAM
2012 National Conference on Health StatisticsMonitoring Health Care Reform through Provider-Based Surveys: New Initiatives from the NAMCS & NHAMCSAugust 8, 2012Anjali Talwalkar, MD, MPHNational Center for Health StatisticsDivision of Health Care Statistics
Slide2NAMCS 2012 Supplements
AsthmaComplementary and Alternative Medicine
Slide3Introduction to Asthma
Chronic respiratory diseaseSymptoms caused by inflammation and narrowing of small airwaysStrategies to control and prevent symptoms exist but are under-utilized
Slide4Asthma Prevalence – United States, 2010
Source: CDC/NCHS, National Health Interview
Survey.
Slide5Asthma Healthcare Utilization – United States, 2009
Source: CDC/NCHS, National Hospital Ambulatory Medical Care Survey.Source: CDC/NCHS, National Hospital Discharge Survey.
Slide6Asthma School and Work Absences – United States, 2009
Source: CDC/NCHS, National Health Interview Survey.
Slide7Management of Asthma
National Asthma Education and Prevention Program (NAEPP) commissioned an Expert Panel to develop clinical practice guidelinesEPR-3 Full Report 2007: Guidelines for the Diagnosis and Management of AsthmaRecommendations organized around 4 key components of asthma managementAssessment and monitoring
Patient educationControl of environmental
factorsPharmacologic treatment
Slide8NAMCS Asthma Supplement
ObjectivesAssess physician use and acceptance of the NAEPP Guidelines for the Diagnosis and Management of AsthmaUnderstand barriers to implementation of GuidelinesInform strategies to increase effective implementation of the Guidelines
Slide9NAMCS Asthma Supplement
Partners Centers for Disease Control and PreventionNational Institutes of Health Environmental Protection Agency American Academy of Allergy, Asthma and ImmunologyMerck Childhood Asthma NetworkRespondentsPhysicians who manage and treat asthmaIncreased sample of pulmonologists and
allergists
Slide10NAMCS Asthma Supplement
Questions evaluate physicians’ acceptance and use of recommended strategiesAcceptance of strategiesAssessment of effectivenessUse of strategiesConfidence in their ability to use strategyPercent of visits where strategy is performedReasons for not using strategy
Slide11NAMCS Asthma Supplement
Content Patient populationPractice workflowAssessment and monitoringUse of spirometry Assessment of controlPatient
educationObservation of inhaler techniqueUse of written Asthma Action Plans
Slide12NAMCS Asthma Supplement
Content Control of environmental factorsAssessment of home triggersRecommendation to avoid secondhand smokePharmacologic treatmentUse of inhaled corticosteroidsRelated additions to Patient Record FormAsthma severity and control assessment
Asthma Action Plan provided
Slide13Health Care Reform and the NAMCS Asthma Supplement
Asthma supplement data will help inform strategies to increase use of the Guidelines and improve patient outcomes Consistent with aim of health care reform provisions to improve the quality of health care
Slide14Introduction to Complementary and Alternative Medicine
CAM encompasses a group of diverse medical and health care systems, practices, and products not generally considered part of conventional medicineComplementary medicine refers to use of CAM together with conventional medicine
Alternative medicine refers to use of CAM in place of conventional medicine
Slide15Introduction to Complementary and Alternative Medicine
CAM Use - 200738% of U.S. adults12% of U.S. childrenCAM Cost and Spending, US Adults - 2007$33.9 billion out-of-pocket on visits to CAM practitioners and purchases of CAM products, classes, and
materials
Source: CDC/NCHS, National Health Interview Survey.
Slide16Introduction to Complementary and Alternative Medicine
CAM checkbox was added to NAMCS Patient Record Form in 2005In 2009, CAM was ordered or provided at 5.38 million visits to office-based physicians
Slide17NAMCS CAM Supplement
ObjectivesDetermine extent to which conventional providers integrate CAM into their patient treatment plansAssess physician reasons for recommending or not recommending CAM therapies to patients
Slide18NAMCS CAM Supplement
SponsorNational Institute of Health’s National Center for Complementary and Alternative MedicineRespondentsFull NAMCS sample
Slide19NAMCS CAM SupplementContent
Recommendation of specific CAM therapies to patientsDiscussion of specific CAM therapies with patientsSymptoms for which CAM is recommendedFactors influencing decision to recommend CAMFactors preventing recommendation of CAM
Slide20NAMCS CAM Supplement
Herbs and other non-vitamin supplementsMind-body therapiesChiropractic or osteopathic manipulationAcupunctureNaturopathic therapyMassage therapyHomeopathic treatmentBiofeedback or hypnosisYoga
Content – CAM therapies
Slide21NAMCS CAM Supplement
UsesOffice-based providers who recommend CAM therapies Specific CAM therapies most frequently recommended and/or discussed with patients
Slide22Contact Information
Anjali Talwalkar, MD, MPHDivision of Health Care StatisticsNational Center for Health Statistics3311 Toledo Road, Room 3228Hyattsville, MD 20782Phone: 301-458-4660Email:
atalwalkar@cdc.gov
NAMCS website: http://www.cdc.gov/nchs/ahcd.htm