Study Shows Asthma Coaches Reduce Rehospitalization
Patients with chronic illness must learn to recognize signs, symptoms, and triggers that exacerbate their condition. Then, they must proactively implement self-care techniques to best manage those symptoms and crises. While physicians prescribe medicines, draw up plans of care and provide instructions for these plans, low health literacy among many patients combined with time compressed office visits often leave patients bewildered when it comes to effectively managing their disease. In a randomized controlled study, Dr. Fisher and his colleagues at UNC at Chapel Hill used asthma coaches in a population of African American children with asthma to bolster health literacy and improve clinical outcomes. Community health workers familiar with the medical terms of an action plan, with good communication skills and the ability to work effectively with parents, served as asthma coaches. Using a coaching style that was both cooperative and supportive, home visit and phone call interventions were tailored to parents’ readiness to adopt the management practices. A coach’s job was to reinforce basic asthma education and encourage key behaviors for managing the disease. Through randomization, the patients received usual care or usual care with the addition of an asthma coach. Over the 24 months of the study, coaches averaged 21.1 contacts with the families. Among the asthmatics receiving this care, 36.5% were hospitalized subsequent to an emergency department visit compared to the 59.1% hospitalized subsequent to an emergency department visit for the asthmatics receiving usual care, a statistically significant difference between the two groups. In the March edition of the Archives of Pediatrics and Adolescent Medicine, Fisher and his colleagues published their findings,
Just When She Thought the Asthma Was under Control
First Friday in First Person. Asthma, which affects about 20 million people throughout the world is defined by the National Heart, Lung and Blood Institute as a common chronic disorder of the airways that is complex and characterized by variable and recurring symptoms, airflow obstruction, bronchial hyperresponsiveness (or bronchospasm), and an underlying inflammation. There have been a number of success stories in the management of asthma, such as Olympic champions Jackie Joyner-Kersee and Dara Torres whose stories are highlighted as a part of the Asthma All-Stars, an innovative campaign by the Breathe Easy Play Hard Foundation. Yet, the fact remains that it is becoming more and more common. Centers for Disease Control and Prevention, its prevalence in US children has increased from 3.6% in 1980 to 9% in 2001, driving families on repeated trips to the emergency room while sufferers in the crisis of an asthma attack, struggle to breathe. Recently, I had the opportunity to become acquainted with Melissa, a blogging mother who has two special needs children. For this month’s personal look inside disease, I’d like to share an experience she and her daughter had with a drug her daughter, Ava was taking to treat her asthma. It not only demonstrates some of the challenges of managing asthma but the type of proactive, informed advocacy that ensures the best care for patients.
Asthma, Allergies and the Air in May
Today is the first day of May and all is enBloom here in Washington, DC. While many of us are continuing to enjoy the beauty of spring and get excited about the arrival of summer, there are many others out there who suffer from allergies and asthma. May is National Asthma and Allergy Awareness Month. All month, we will focus our attention on asthma, air quality and air pollutants, including tobacco, in addition to the normal banter around health policy, politics, health reform and ARRA. Look out for ways to educate yourselves and participate in this month’s featured health observances.
