Allergy and Airway |

Utilizing Asthma Navigators to Improve Asthma Control FREE TO VIEW

Tyra Bryant-Stephens, MD; Caroline West, MPA
Author and Funding Information

The Children's Hospital of Philadelphia, Philadelphia, PA

Chest. 2014;145(3_MeetingAbstracts):16A. doi:10.1378/chest.1836296
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SESSION TITLE: Asthma Posters

SESSION TYPE: Poster Presentations

PRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PM

PURPOSE: Children with asthma frequently seen in the emergency room and hospital often lack care coordination and are discharged to poorly resourced and/or chaotic environments. Affected caregivers may benefit from a central healthcare liaison who equips them to navigate clinical asthma management. The purpose of this study is to determine whether asthma education and care coordination conducted by practice-based asthma navigators improves asthma control for children. This is a preliminary report of the first 76 families enrolled and followed for one year.

METHODS: Children ages 0- 16 years old who have moderate or severe persistent asthma with 1 inpatient or 2 ED visits in the past year. Once consented, caregivers complete a needs assessment which informs care coordination goals. In the practice, families receive asthma education, care coordination resources and are taught how to properly use asthma devices by the asthma navigator. AN’s conduct three home visits tailored to help identify and reduce asthma triggers. AN’s also meet families at follow up visits at 3-, 6-, 9- and 12 months in the practices to assess asthma control, monitor progress of attaining goals, reinforce asthma management principles and provide asthma management resources as needed.

RESULTS: Mean age is 4.83 years and 65% are male. 90% of the caregivers are mothers. 88% are African American. 86% of the caregivers have completed high school and 9% have completed college. At baseline, 1/3 were well-controlled, 1/3 poorly controlled and 1/3 uncontrolled.Compared to baseline there was a mean reduction of 2 days in use of albuterol (p.001) at 12 months.There was a mean reduction of 3 days in daytime (p.001) and nighttime asthma symptoms (p.002) at 12 months. Emergency room visits were reduced by 69% (p.000) and inpatient visits by 76% (p.001) compared to the year prior to enrollment. Top goals met were: learn how to use asthma medicines (92%), reduce asthma triggers (98%), make and keep follow-up appointments (80%).

CONCLUSIONS: Preliminary results indicate that integrating community health workers as asthma navigators into primary care offices helps families of children with moderate and severe persistent asthma improve asthma control. Future analysis will compare this cohort to a prospective case-matched control group

CLINICAL IMPLICATIONS: The use of non-traditional health care workers in the clinical setting is feasible and supports the transition to activated patient and proactive health care team.

DISCLOSURE: The following authors have nothing to disclose: Tyra Bryant-Stephens, Caroline West

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