Complex Pediatric Asthma: Looking Back & Looking Ahead
On December 10th, 2021, our program hosted the final session of our Complex Pediatric Asthma: Beyond the Guidelines series! The series launched in 2016 to help address the disparities in asthma care and management on the south side of Chicago, where the rate of pediatric asthma is far higher than it is elsewhere in our country and disproportionately impacts children of color. As with all our ECHO series, we hope to help break down some of the barriers to care and ultimately improve outcomes for patients through information sharing and case discussion with participating providers.
The cohort that just wrapped up was our 10th. We are proud to have trained 112 providers from 49 organizations, spanning 11 states. We also had 171 cases shared by providers, which covered a wide variety of topics. Some cases focused on very clinical topics like how to choose the right medication and when to “step up” or “step down” dosing based on current guides and guidelines. Other cases helped orient the conversation towards more social and environmental facets of care, like using green cleaning products or reducing smoking in the home to help mitigate asthma symptoms.
The curriculum for the series mirrored this same holistic stance towards asthma management. Some sessions addressed medical factors impacting care, such as correct diagnosis & medication management, lung function testing, differential diagnosis, and epidemiology. Other sessions shared tips on environmental management, complementary treatment options, inhaler technique, and co-managing asthma within the school or other systems. The facilitation team was just as diverse as the range of topics and included a pediatric pulmonologist, a pediatrician, an advanced practice nurse with a specialization in asthma who could speak to medically managing asthma and a community health worker who could share her experience in patients’ homes and communities. This was just one of many ways that this series was a unique one!
Another way this uniqueness was showcased was through the featuring of a Caregiver Voice Representative. For three of our ten cohorts, we were fortunate to have a parent or caregiver come and share their experience managing asthma in the home and provide advice to participating providers about how to engage caregivers as part of the care team while also empowering their pediatric patients to advocate for their own care. The caregivers who joined us came to the program from a variety of avenues, including one caregiver who joined our Asthma for Caregivers series and a parent who has also been part of our Community Advisory Board since the series began.
Lastly, the series offered an innovative, hands-on approach to teaching when appropriate. Improper inhaler technique is one of the most common reasons for poorly managed asthma, according to our expert facilitators. Thus, beginning in our 5th cohort we began an initiative to practice inhaler technique during the series. Each participating provider was mailed a teaching inhaler (one with no medication in it) and spacer. Then, providers were given the opportunity to be shown correct inhaler technique by our facilitation team and then had the opportunity to practice it themselves!
Over the last 5 years, this project has been funded through grant H17MC30729 from the Health Resources and Services Administration (HRSA) and the Health Tomorrows program at the American Academy of Pediatrics. Additional funding has been provided by UChicago Medicine’s Urban Health Initiative and the University of Chicago’s Department of Pediatrics. While we’re sad to see this chapter of the asthma program end, we are grateful for the experience we have gained over these past few years and are excited present new iterations of the program in the future.
We are also excited to share ways you can learn more about the program and about asthma management. Our very first podcast episode was about this series, and can be found here. We also highly recommend the South Side Pediatric Asthma Center (SSPAC) for more information including instructions for making your own green cleaning products, videos demonstrating proper inhaler technique, and an asthma resource line. We will continue to share the data from this series after the analysis process wraps up and look forward to continuing to share the impact of this series with you all!
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