Thousands of pediatric asthma sufferers in Ohio are now getting coordinated care through a multi-million dollar initiative to align the state’s children’s hospitals.
Gov. John Kasich in 2011 pledged $2 million in research funds to improve the health of Ohio’s children. Last week, he pledged a second round of $2 million to support expanded asthma research and pediatric pneumonia research.
“Forty to seventy percent of kids don’t respond well to current therapies; asthma is really hard to treat,” said Dr. Gurjit Khurana Hershey, professor and director, Division of Asthma Research at Cincinnati Children’s Hospital Medical Center.
Cincinnati Children’s is leading the asthma research that started in 2013 with creation of the Ohio Pediatric Asthma Repository (OPAR) that now includes over 3,000 pediatric asthma patients from the state’s six pediatric hospitals, including in Dayton, Columbus and Cleveland.
“In the first round of funding we found substantial differences in care,” Hershey said.
Information tracked on the OPAR is the patient’s clinical, demographic, adherence, environmental and health outcomes data. The repository tracks the success of the patient and each hospital’s approach to treating asthma.
“Now we’re trying to understand the differences to identify which practices have the best outcomes,” Hershey said. “Then we can implement those processes across all hospitals.”
Asthma, a chronic inflammatory disorder of the airways, affects 25 million people in the United States and costs $56 billion per year in medical expenses, lost school and work days, and early deaths, according to the Centers for Disease Control and Prevention.
Asthma — affecting 7.1 million U.S. children — is one of the leading causes of avoidable hospital admissions for children. In 2008 in Ohio, over 15 percent — 419,000 children — were diagnosed with asthma, according to the Ohio Family Health Survey.
Hershey said one goal in the second round of funding is to add genetic biomarkers to the repository, including a patient’s blood and DNA, in order to personalize care for each patient.
“Not everyone has the same kind of asthma; it’s hard to identify triggers,” Hershey said, such as a pet allergen, viral infections, outside pollutants and changes in weather.
Hershey said the type of treatment depends on the type of trigger, but commonly includes a rescue inhaler to use when wheezing and coughing and a control inhaler to act as an anti-inflammatory to help breathing.
Hershey said one example of an early success using the repository was identifying a drug used at two of the six hospitals that was not helpful in treating the patient’s asthma. She said that drug is no longer used at the two hospitals.
“It removes costly practices that aren’t improving care,” Hershey said.
In Gov. Kasich’s first round of funding in 2011, $1 million over two years supported asthma research, with another $1 million for developing new treatments for babies born addicted to drugs.
In this latest round of funds, $1 million will support continued asthma research and $1 million to launch pediatric pneumonia research. Pneumonia is the leading cause of death in children under 5.
Ohio’s children’s hospitals will partner with Ohio Medicaid to capture Medicaid costs for both research efforts and document improvement in health outcomes.
Funds for both projects are from the Children’s Health Insurance Program Reauthorization Act performance bonus Ohio received for enrolling more eligible children in Medicaid and CHIP.
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