First Multidisciplinary Center For The Treatment Of Asthma Opens In The Midwest

Main Category: Respiratory / Asthma
Article Date: 21 May 2009 - 6:00 PDT

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Rush University Medical Center has opened the first multidisciplinary center in the Midwest for the treatment of asthma, addressing a chronic respiratory disease that affects 22 million Americans, including 6 million children.

Chicago is one of the epicenters of the disease, leading the country with the highest number per capita of asthma-related deaths, emergency room visits and hospitalizations.

The new Rush University Asthma Center brings together expertise in clinical care, patient education, and research in an intensive effort to improve the overall health and well-being of asthma patients of all ages. The multidisciplinary team includes allergists, pulmonologists, gastroenterologists and ear, nose and throat physicians.

"Asthma is a complex disease that takes a heavy toll on patients, families, and society," said Dr. Mary Kay Tobin, allergy/asthma specialist and managing director of the asthma center. "But there are ways to improve outcomes for asthma patients, and that is by taking a multidisciplinary approach that incorporates state-of-the-art diagnostic technology and treatment, education in self care and basic and clinical research to advance new therapies."

The disease varies widely. In some individuals, asthma is characterized by chronic respiratory impairment. In others, it is an intermittent illness marked by episodic symptoms that may result from a number of triggering events, including upper respiratory infection, stress, airborne allergens, air pollutants (such as smoke or traffic fumes), or exercise. In children, asthma sometimes occurs only at night.

Symptoms can be mild or severe, or even unresponsive to treatment. Sinusitis, irritable bowel syndrome, sleep problems, gastroesophageal reflux, and other disorders may accompany asthma.

Clinical care at Rush's new asthma center starts with a comprehensive evaluation by specialists in allergy and pulmonary medicine that incorporates diagnostics, therapeutics, and preventive care, all in a patient-friendly environment. The initial visit includes individualized diagnostic tests; an assessment of environmental factors that might be contributing to the illness at home, daycare, or school; treatment; and preventive care. The physician prescribes an action plan, which includes medication prescriptions and one-on-one instruction to help patients learn to cope with their disease through preventive and other measures.

If necessary, the center brings in other specialists for consultations, such as otolaryngologists and gastroenterologists. The center also coordinates any needed tests, such as an exhaled nitric oxide test to help quantify the level of active inflammation in patients over the age of 5. A state-of-of-the-art impulse oscillometry system at Rush allows physicians to test lung function in younger children.

In the return visit two weeks later, the physician reviews the test results and modifies the action plan, if necessary. The patient may receive referrals for a home visit, pest control, and school programs, as well as further individual and group instruction to reinforce lessons in self-care and prevention.

"Education is a crucial component of the care, to teach patients or, in the case of children, their parents or caregivers, what asthma is, what the environmental triggers are, what to do in case of an acute asthmatic attack, and how to use medical equipment such as nebulizers," said Dr. Girish Sharma, director of pediatric pulmonology. "Return visits enable us to monitor whether patients are following the prescribed course."

In research, the center's aim is to bridge the gap between pharmacological, physiological and immunological investigations in developing new treatments for asthma. The center is building a repository of tissues donated by asthma patients, to be used in both basic and applied studies.

"Rush recognizes that advances in patient care are dependent on improved understanding of the disease process," said Alan Landay, PhD, chairman of the department of immunology and microbiology. "Our research focuses on bringing advances from bench to bedside, and then out to the community."

Over time, the center expects to develop community outreach programs that provide education and resources for neighborhoods and schools where the incidence of asthma is high.

"With a multidisciplinary approach, we can greatly improve the outcomes for our patients," said Dr. Robert Balk, director of pulmonary and critical care medicine. "That means fewer emergency room visits and hospitalizations, fewer missed days at school and work - and improved quality of life."

Source
Rush University Medical Center

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