ACES: A Program to Improve Asthma Outcomes in a High-Morbidity Pediatric Population

The goal of this project was to determine if a nurse practitioner (NP) designed and managed primary care based asthma quality improvement (QI) program titled Asthma Control and Elimination of Symptoms (ACES) could improve asthma outcomes in a high-morbidity pediatric population. A convenience sample of 31 children age 2 to 17 years with persistent asthma were recruited from a private practice in a rural community to participate in this prospective study with 3 months of follow-up. The primary outcome measures were symptom improvement and use of symptom prevention medication. The secondary outcome measures were reduced ED visits and hospitalizations. Participants in the ACES program had significant improvement in daytime asthma symptoms, nighttime asthma symptoms, use of rescue medication, activity tolerance, missed school days, attacks lasting longer than 24 hr, and use of symptom prevention medication. There was a decrease in ED visits and no change in rate of hospitalizations. One hundred percent of participants completed the program and the QI project improved health outcomes of all children in the program.