Leah Joseph uses a spacer as part of her treatment at the Kings County Hospital Pediatric Asthma Center.

Baby Davon was only three months old when an asthma attack first sent him to the emergency room at Kings County Hospital. Luckily, Kings County was his medical home and his pediatrician was able to immediately refer Davon to the asthma clinic there where they not only treated him, but also educated his mother about the care he needed.

"I made some major changes in our home, taking out the carpet and drapes, putting in a HEPA filter," said Davon’s mother, Ann-Marie Williams. “It's important for him to have the right home environment because he spends so much of his time here."

Under the careful treatment of Dr. Diana Weaver, eleven-year-old Davon has been able to reduce his trips to the hospital significantly. And last year he missed four days of school -- a big improvement over the 18 days he missed three years ago.

"Asthma symptoms occur when a patient has a hyper-reactive airway, which becomes inflamed and swollen, making it increasingly difficult to breathe," said Dr. Weaver.

Davon is among the roughly 17 percent of New York City students who suffer from asthma, the leading cause of missed school days and one of the major causes of emergency room visits and hospitalizations for children under 14 yrs. Last year, one out of every five New York City student missed a month or more of school -- that’s approximately 250,000 students.

HHC physicians like Dr. Weaver have been meeting those devastating statistics with an aggressive approach that has been increasingly effective in helping patients manage their asthma, stay in school, and stay out of emergency rooms and the hospital.

Since 2007, HHC pediatricians, nurses, asthma specialists and health educators have been practicing a patient-centered asthma management and care program that follows proven treatment protocols and federal guidelines established by the National Institutes for Health. They consistently prescribe the most effective asthma medications and work closely with families and schools to create a customized asthma action plan for each patient that outlines when and how to give these medications and when to seek urgent medical care.

“An effective regimen of preventive medication can make the difference between regular visits to the ER and a normal, active lifestyle,” says Dr. Weaver. “We know that the most severe symptoms of asthma can be prevented by avoiding triggers, such as smoke, dust or pollen, and regularly taking anti-inflammatory medication.”

As part of HHC standard practice, children like Davon usually receive a prescription for a daily inhaler which contains a corticosteroid, and they sometimes also need daily oral medication. All pediatric asthma patients also receive another inhaler which contains a bronchodilator to quickly open up tight airways during an acute attack

This consistent approach to pediatric asthma care has made a measurable difference among patients covered by HHC’s MetroPlus Health plan. MetroPlus has seen a six percent decline in the rate of asthma-related pediatric emergency visits and a 25 percent decline in the rate of pediatric hospital admissions for children being treated across all the HHC hospitals over the last five years. This steady decrease in the rate of hospitalizations has continued during a time when the health plan has significantly increased membership and the number of children with asthma covered by the plan.

At Kings County, Dr. Weaver reports an equally dramatic decrease in their entire population of pediatric asthma-related ER visits and hospitalizations. Asthma admissions dropped by 33 percent from 641 in 2004 to 429 in 2010, while pediatric asthma ER visits decreased by 34 percent, from 2,496 in 2004 to 1,714 in 2010.

Desire LaTempa, coordinator of the asthma education program at Woodhull Medical Center in north Brooklyn, says part of their success had depended on taking her asthma prevention work outside the hospital walls. As Chairperson of the North Brooklyn Asthma Action Alliance, she brings training from the hospital to the community, giving individual education session to teachers, school nurses and custodians, and managing asthma workshops for parents, students and other school staff.

“To make sure patients follow their treatment protocols and use their prescribed medications we have to engage them in a lot of education for both the children and their parents,” says LaTempa.

August 2011