Chest
Original ResearchMultidisciplinary Approach to Management of Maternal Asthma (MAMMA): A Randomized Controlled Trial
Section snippets
Materials and Methods
A single-blind randomized controlled trial was carried out in the antenatal settings of two large maternity hospitals in Victoria, Australia, to evaluate MAMMA intervention. The detailed protocol is published elsewhere.21 The study design and flow of participants are shown in Figure 1.
Results
Sixty participants from a range of ethnic and socioeconomic groups were recruited into the trial. At baseline, the groups were well matched (Table 1). All participants reported that they were nonsmokers or had quit smoking upon confirmation of pregnancy. At the baseline interview, 42 participants (70%) revealed that they were unaware of the risks of poorly controlled asthma, and 19 (32%) reported ceasing or reducing their medications since becoming pregnant. Sixteen participants (27%) (10 in
Discussion
This trial shows that an intervention comprising education, surveillance, and multidisciplinary management can successfully overcome barriers to asthma management in pregnancy, translating into improved asthma control. This intervention is simple and could be easily implemented in antenatal settings with minimal additional resources. Although the intervention was pharmacist led, it could potentially be delivered by any member of the health-care team with additional training in asthma
Conclusions
The MAMMA trial has shown that actively managing asthma through education and regular monitoring by a pharmacist-led multidisciplinary team can improve asthma control during pregnancy. Empowering women to take control of this common chronic health condition and providing them with more support services will reduce the burden of asthma during pregnancy and potentially reduce poor health outcomes associated with exacerbations.
Acknowledgments
Author contributions: Dr George had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Ms Lim: contributed to the trial design and management, participant recruitment, baseline data collection, data entry, drafting of the manuscript, and editing the manuscript based on comments and feedback from the other authors.
Dr Stewart: contributed to the trial design and review of the manuscript.
Dr Abramson: contributed to
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Part of this article has been presented as an oral presentation at the Tackling Asthma 2013 Conference, March 19-20, 2013, Canberra, ACT, Australia; as a poster presentation at the Thoracic Society of Australia and New Zealand Annual Scientific Meeting, March 23-27, 2013, Darwin, NT, Australia; and as a poster presentation at the European Academy of Allergy and Clinical Immunology & World Allergy Organization World Allergy & Asthma Congress, June 22-26, 2013, Milan, Italy.
Funding/Support: The authors have reported to CHEST that no funding was received for this study.
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