Associate chief of emergency medicine receives $2.2m award for asthma studies

Stephen J. Teach, MD, MPH, Associate Chief of Emergency Medicine at Children's National Health System, says that aggressively managing parental stress and using cell phone apps to monitor medication usage in at-risk youth with asthma may improve children's adherence to asthma medications.

Teach recently received a $2.2 million award from the Patient-Centered Outcomes Research Institute for a three-year project to determine whether parents' use of cell phones can succeed as part of a stress-management program for parents of at-risk youth with asthma.

While cell phones are used to help manage chronic diseases including asthma in children, there hasn't been a study examining a stress management program using cell phone apps or tools as a means to track medication usage, Teach says.

At-risk youth with asthma have a lower likelihood of following preventative medication regimens, he says. When parents are unable to follow asthma management plans, and particularly when they do not consistently give their children their daily inhaled controller medications, asthma outcomes can worsen, Teach adds.

Asthma flare-ups, emergency department visits and hospital admissions are much more common among poor African-Americans and Hispanics living in cities than among other children with asthma.

Reducing stress among parents and children may help them maintain medication protocols and improve asthma outcomes, Teach says.

"There is a pressing need to study whether reducing parents' stress will increase their children's use of daily asthma controller medications," says Teach, also Director of the IMPACT DC program in the Children's National's Center for Translational Science. "We will hopefully be able to track actual usage of the medication in the home with an adherence device," he says. "We predict that the stress management program will increase the amount of daily controller medications taken."

Teach says researchers expect to target at-risk youth, ages 4 to 12, with severe asthma. At least 250 youth will be evaluated. Researchers will track their medication use "and help when that use drops off, using real-time help when it fails," Teach says.

Children's National has developed a unique program (IMPACT DC) that follows national guidelines for asthma care that focuses on urban youth with asthma who make frequent visits to the emergency department. Medication adherence is a major concern among families and care givers of children with asthma. While patients in the program take more daily controller medications than those not in the program, actual use remains just under 50 percent, Teach says.

A stress management program and tracking of medication use for an at-risk population "is very important," Teach says. "It will give parents and doctors more choices in caring for children. medications taken."

Provided by Children's National Medical Center