Evolving Asthma Care for the Biggest Impact

We have seen the positive impact of tailored, community specific approaches to manage asthma better; we must continue to support this work. Let's not only renew our focus, but disrupt the status quo to advance the evolution in care and research -- we owe it to those seven plus million children living with asthma.
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Reports of asthma go back to the Ancient Greeks when treatment consisted of inhaling the fumes of an herb mixture heated on bricks. Overtime, treatment regimens evolved from the use of alcohol, tobacco and chloroform to psychoanalysis and talk therapy. And until asthma was recognized as an inflammatory disease in the 1960s, patients weren't always considered to be afflicted with a physical illness, let alone a chronic condition.

In the past 60 years, research and treatments continued to evolve and the focus on evidence-based medicine led to improved management as well as quality of life for many. However, 1.8 million asthma diagnoses are still made in hospital emergency rooms with an average hospital stay of 3.6 days. And worse, children have two times the rate of emergency room visits compared to adults. We still have so much farther to go.

May is the month when we come together as a community to assess the evolution in asthma care. During National Asthma Awareness Month countless advocates, physicians, scientists, caregivers and patients join forces to increase awareness of effective treatment and management of this chronic disease. We come together to examine the current state of research, treatment and interventions and reassess our collective path forward.

There is more we can and must do to evolve successful and targeted management to have a positive impact on the lives of those living with asthma. I believe some of the most important strides in asthma management are community-based programs, especially those designed to reach children in convenient places where they live, learn and play. This approach is vital to reaching the most vulnerable in our society who live in impoverished communities.

These programs make sense, especially as we learn more and more about the multitude of environmental and socio-economic factors that impact asthma. A study published this February in Pediatrics reported that children exposed to mold or moisture damage in their living rooms, kitchens or bedrooms are more likely to develop childhood asthma. Johns Hopkins University School of Medicine research found asthma to be more prevalent in poverty-stricken areas with a higher rate among African American and Puerto Rican children. And, just last month, President Obama emphasized the impact of climate change on health, particularly asthma.

So it's no surprise that we see a positive impact on asthma when community health workers, physicians, school nurses and caregivers work together in neighborhoods where asthma is poorly controlled. Through the efforts of the nonprofit Merck Childhood Asthma Network, Inc. (MCAN) we've supported such programs in Chicago, Philadelphia, Los Angeles, New Orleans, Phoenix, Grand Rapids, as well as sites in Puerto Rico. Our programs have succeeded in improving the quality of life for children with asthma and their families as well as reducing hospital and emergency room visits.

And we are not alone. Others are successful in similar interventions with children and their families. Recent research from Kaiser Permanente found a low cost, phone call reminder program to parents increased appropriate taking of asthma medications by their children.

We must maintain momentum on these community-based efforts and build on them. Let's follow the lead of the National Institutes of Health (NIH) and the Patient Centered Outreach Research Institute (PCORI) to drive more "real world" community-based programs and research across the nation and globe.

We have seen the positive impact of tailored, community specific approaches to manage asthma better; we must continue to support this work. Let's not only renew our focus, but disrupt the status quo to advance the evolution in care and research - we owe it to those 7+ million children living with asthma.

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