Improving the Quality of Life for Children Living with Asthma

07 Aug 2013
Poorly controlled asthma reduces the quality of life for children and adults and dramatically drives up the total cost of their care. According to the Mayo Clinic, the disease is also the leading cause of Emergency Department (ED) visits, hospitalizations, and missed school days. With more than 10 million children affected, pediatric asthma is the most common childhood chronic disease in the country, according to the Centers for Disease Control and Prevention. In Missouri alone, the number of children diagnosed with the disease exceeds 150,000, the largest number of whom (14.8 percent) reside in the Kansas City metro area. To help combat the disease, the greater Kansas City’s area AF4Q Alliance, led by the Kansas City Quality Improvement Consortium (KCQIC), has teamed up with Asthma Ready Communities (ARC) of the University of Missouri Health Systems to conduct a community project, KC TUAC.
KC TUAC builds on the Asthma Ready Program (ARP) in cooperation with the Missouri School Boards’ Association. The program provides free, evidence-based, multimedia asthma education to children and school nurses. School nurses who were asked to complete a survey and provide feedback on how students benefited from TUAC indicated:
“The education provided in the video really helped my students have a better understanding of their asthma and the proper management.”
“I was able to work closely with a student who otherwise would have no intervention, significantly improved his understanding of asthma, improved his inhaler technique, and fostered independence and ownership of his asthma.”
Paul Foreman, MS, MA, PhD, project director, Asthma Ready® Communities, indicated there are many interventions that could work, but it takes a collaborative model to sustain the efforts over time. “We all need to keep our eyes on the children,” he said. Fostering a community approach, KC TUAC is also targeted toward area pediatric primary care providers (PCPs). The PCPs are identified by school enrollment forms provided by parents and from parents themselves. If the child does not have a PCP, a referral is provided to the parents. 
TUAC program effectiveness for school nurses and students participating in the pilot was assessed through pre- and post-evaluation school visits. A total of 82 students, ages 5 to 11, were evaluated. A 15 percent increase in forced expiratory volume in one second (FEV1) was noted for participants. The effort also contributed to $1,281,720 in savings in the Kansas City Area by preventing asthma-related hospital readmissions.
KC TUAC is the first of its kind in the country where students report to school nurses, who connect directly with PCPs. The collaborative effort is already improving the lives of children in the affected communities. Eighty-seven percent of school nurses and 93 percent of parents recommend TUAC. Positive preliminary findings have prompted further expansion and development of protocols to improve pediatric asthma control through TUAC.