Asthma is a devastating chronic
disease that affects up to 24 million Americans. It is more severe and prevalent among African
Americans and Hispanics, especially Puerto Ricans. There’s a two-fold increase in asthma
mortality in Hispanic children and three-fold among African Americans, compared
to Whites. The causes of these
disparities are complex, but are undoubtedly worsened by the observation that
they are less likely to be treated according to the National Asthma Education
Prevention Program (NAEPP) guidelines, which have been widely available for the
past 20 years. To address these issues,
the Patient-Centered Outcomes Research Institute (PCORI) funded 8 studies to
help patients and clinicians adhere to the guidelines. In this month’s issue of the Journal of
Allergy and Clinical Immunology, Anise and colleagues review these 8 randomized
control trials (J Allergy Clin Immunol 2016; 138(6): 1503-1510).
Among the approaches being used are
(1) clinician education, (2) clinical decision support, (3) patient education
in the ER and clinic, (4) use of community health workers, and (5) use of
long-term and quick-relief medications.
While each study has a distinct focus, all of them overlap in
incorporating relevant stakeholders into the projects, and aligning local
resources towards overarching, generalizable goals.
The research projects are still
underway, and results will not be available for at least two more years. But these research projects are pioneering in
the way that they are putting research in action in local communities, and
embracing multi-faceted approaches with the understanding that single
interventions may not be effective.
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