Asthma in children needs persistent care

Cases treated as an acute condition too often

Pierre Vauthy, M.D., is director of Pediatric Pulmonary Medicine and Pediatric Critical Care at ProMedica.

Pierre Vauthy, M.D., is director of Pediatric Pulmonary Medicine and Pediatric Critical Care at ProMedica.

This is one of a series of columns about health issues written by staff members of ProMedica, Mercy, Toledo Clinic, and the University of Toledo Medical Center, the former Medical College of Ohio.

There is no cure for asthma, and its cause is unknown.

During an attack, airways in the lungs become inflamed, making it hard to breathe. Asthma attacks can be mild, moderate, or serious — and even life threatening.

The Centers for Disease Control (CDC) reports that one in 11 children in the United States is diagnosed with asthma, and 13.7 percent of children in Ohio are asthmatic.

“Asthma is a chronic disease and should be treated as such,” says Pierre Vauthy, M.D., a ProMedica Physicians pediatric pulmonologist who has cared for children with asthma and other lung conditions for more than 30 years. “Compared to when I started in practice, we are now better able to diagnose the condition, recognize the triggers, and know how to treat new attacks right at the time they begin.”

But all too often, Dr. Vauthy and the team at the Asthma Disease Management Program at ProMedica Toledo Children’s Hospital encounter cases where asthma is being treated as an acute condition.

“The patient gets treatment, goes home, and may or may not get the necessary follow-up care and education needed to help control the disease,” Dr. Vauthy says. “Children need proper, consistent medical care to manage this disease. When their asthma is controlled with routine care and education, they are less likely to visit emergency departments for asthma-related treatments.”

ProMedica Toledo Children’s Hospital is the only hospital in Ohio with a Disease Specific Program — Pediatric Asthma certification from The Joint Commission — and is one of nine hospitals in the United States to receive this status. This national recognition represents a commitment to meeting certain performance standards of excellence. It’s a voluntary accreditation, but Dr. Vauthy and the staff feel it’s a validation of what sets their program apart from others.

“Studies suggest that about one-third of patients use their inhalers improperly," Dr. Vauthy says. "This includes improper timing, or they may administer the medicine incorrectly. We have a team of dedicated asthma educators [certified or obtaining certification] available seven days a week, for both inpatients and outpatients. Teaching children how to manage asthma on their own is one of the most important parts of controlling the disease. We also believe asthma management is more successful when a program offers a multidisciplinary treatment team approach. We have physicians, respiratory therapists, asthma educators, dietary, and social workers all working from a plan that they helped develop specifically that patient."

For many asthma patients at ProMedica Toledo Children's Hospital, the physician they see at their follow-up appointment will look familiar. That's because it will be the same one he or she saw as an inpatient. "It's important that the patient works closely with their asthma specialist or primary doctor so that the pattern of asthma symptoms can be followed," Dr. Vauthy says. "This gives us the opportunity to check asthma control even when the child is well. We may adjust the preventive medicines to the lowest effective doses. We can discuss the child's side effects, and again, make sure the medicine is being taken properly, including spacer use."

The program also helps families identify any problems they might have with getting the care they need including insurance coverage, access to appointments, and the ability to get medicine.

According to the CDC, boys are more likely than girls to have asthma and black children are twice as likely as white children to have asthma. Asthma keeps children out of school, disrupts their usual activities, and accounts for significantly more hospital emergency room visits than other conditions. Asthma is an economic concern, costing the United States $56 billion each year.

Pierre Vauthy, M.D., is director of Pediatric Pulmonary Medicine and Pediatric Critical Care at ProMedica. For more information, go to promedica.org/​asthma.