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Asthma Quality Network Newsletter

June 2010

Table of Contents


Program Update

Clinical Asthma Education Specialists FY11 Grants
MaineHealth is pleased to announce that Maine Medical Center, Southern Maine Medical Center, and MidCoast Hospital will be receiving grants in FY11 to support asthma education programs. On-site educators are available at these three hospitals to work with patients with asthma. Click here for a fax referral form to contact the nearest asthma educator.


COPD Clinical Specialist Position
A COPD Clinical Specialist position is available to support our work in COPD in practices, hospitals, and home health agencies. This part-time clinical specialist in COPD  will provide clinician education as well as develop protocols for standardized, evidence-based transitions of care.  Click here for more information and forward to anyone that you think might be interested in and qualified for the position.

Asthma News

 Upcoming Conferences:

  • Managing the Cost of Asthma in Maine Business
    This half day program features the recently released Asthma: A Business Case for Employers and Health Care Purchasers report, from the Asthma Regional Council of New England. For more information and a registration form visit

    Friday June 25, 2010
    7:45 - 12:00
    Holiday Inn by the Bay - Portland
  •  COPD Educator Institute
    Mark your calendars for the Fall COPD Educator Institute to be held at Southern Maine Medical Center on November 11th and 12th. For more information, contact Lee Gilman at the American Lung Association in Maine.
  • The National Agenda for Safe and Healthy Housing
    Rebecca Morley, Executive Director of the National Center for Healthy Housing will give an overview of the National Safe and Healthy Housing Coalition's (NSHHC's) policy agenda which includes 1) Creating Healthier Housing through Standards, 2) Integrating Energy Efficiency & Healthy Housing, and 3) Financing Healthy Housing.

    Wednesday, June 30, 2010
    3:00-4:00pm EST
    Click here to register

 AARC- The Year of the Lung
Click here to read a press release by the American Association of Repiratory Care highlighting the "Year of the Lung" as a key time to focus on asthma control with quotes by MMC's, Rhonda Vosmus, RRT, AE-C.


AH! MMC published in June issue of CHEST Physician
An article written by Christopher Hirsch, MPH, RRT, Barbara A. Chilmonczyk, MD and Rhonda Vosmus RRT, AE-C describes the community-based, comprehensive approach to asthma education that engages parents, patients and providers in the guideline-based care of asthma which has resulted in a consistent reduction in reported ED visits, hospitalizations, and missed school/work days across all age groups after participation in the program. For copies, contact Paula Gilbert from the MMC AH! Program.

Clinical Update


  • Step-up Therapy for Children with Uncontrolled Asthma
    Receiving Inhaled Corticosteroids
    The New England Journal of Medicine, March 18, 2010
    Background- For children who have uncontrolled asthma despite the use of low-dose inhaled corticosteroids (ICS), evidence to guide step-up therapy is lacking.
    Methods- We randomly assigned 182 children (6 to 17 years of age), who had uncontrolled asthma while receiving 100 μg of fluticasone twice daily, to receive each of three blinded step-up therapies in random order for 16 weeks: 250 μg of fluticasone twice daily (ICS step-up), 100 μg of fluticasone plus 50 μg of a long-acting betaagonist twice daily (LABA step-up), or 100 μg of fluticasone twice daily plus 5 or 10 mg of a leukotriene-receptor antagonist daily (LTRA step-up). We used a triple-crossover design and a composite of three outcomes (exacerbations, asthma-control days, and the forced expiratory volume in 1 second) to determine whether the frequency of a differential response to the step-up regimens was more than 25%.
    Results- A differential response occurred in 161 of 165 patients who were evaluated (P<0.001). The response to LABA step-up therapy was most likely to be the best response, as compared with responses to LTRA step-up (relative probability, 1.6; 95% confidence interval [CI], 1.1 to 2.3; P = 0.004) and ICS step-up (relative probability, 1.7; 95% CI, 1.2 to 2.4; P = 0.002). Higher scores on the Asthma Control Test before randomization (indicating better control at baseline) predicted a better response to LABA step-up (P = 0.009). White race predicted a better response to LABA step-up, whereas black patients were least likely to have a best response to LTRA step-up (P = 0.005).
    Conclusions- Nearly all the children had a differential response to each step-up therapy. LABA step-up was significantly more likely to provide the best response than either ICS or LTRA step-up. However, many children had a best response to ICS or LTRA step-up therapy, highlighting the need to regularly monitor and appropriately adjust each child's asthma therapy. ( number, NCT00395304.)
    Click here to read this article.
  • Traffic, Susceptibility, and Childhood Asthma
    Asthma episodes are triggered by many different allergens and irritants. Community asthma programs strive to implement policies and activities that address environmental triggers that are likely to impact large numbers of patients with asthma. Dr. Robert McConnell and colleagues examined the relationship of local traffic-related exposure and asthma and wheeze in southern California school children (ages 5-7). Asthma and wheeze were strongly associated with residential proximity to a major road. These associations were strongest among children with no parental history of asthma who had lived at the same address since early in life. To learn more about this study, visit the Environmental Health Perspectives Journal.

Asthma Tools and Resources 


  • Health Literacy for Public Health Professionals
    This new, free, web-based training gives you practical strategies, tools, and resources about health literacy that you can apply in your public health practice. Continuing Education Credits available. Click here for more information.
  •   National Environmental PH tracking network website
    The National Environmental Public Health Tracking Network is a system of integrated health, exposure, and hazard information and data from a variety of national, state, and city sources. Click here for more information.
  • Childhood Asthma and Environmental Health
    Dr. Malveaux with the Merck Childhood Asthma Network provides some steps the nation can take to improve outcomes for children with asthma and others with underlying diseases affected by the environment.  What changes have you made on the community level?  Join the discussion by posting a comment about this topic here.  
  • Asthma Community Network
    The EPA's asthma website,  will debut a new design, along with an improved set of tools and resources to help you advance asthma care in your community. The website enhancements will provide you greater flexibility to contribute content and to improve how you can share, learn and connect with other community-based programs.
  • Website to Support Pediatricians
    Click on  to learn about how to support making children's homes smoke free. This site includes resources, information, ideas and opportunities for collaboration in the battle against secondhand tobacco smoke exposure of children.
  • Free Asthma Screenings Available This Spring
    Help people in your community get a free asthma screening.
    The American College of Allergy, Asthma & Immunology is sponsoring a nationwide program with events in more than 200 locations across the country. Find a screening in your area today.
  • New National Childhood Asthma Media Campaign
    The Advertising Council, in partnership with the U.S. Environmental Protection Agency (EPA), has launched a new series of Public Service Announcements (PSAs) designed to inform parents and caretakers of children living with asthma that serious asthma attacks can be prevented and to motivate families to learn how to take action. The new television, radio and web PSAs (available in English and Spanish) provide new and simple actions to limit environmental asthma risk factors. Read more about the new PSAs (English, Spanish).
  • Worst Cities for People with Asthma
    The Asthma and Allergy Foundation of America (AAFA) recently released its 2010 national 'Asthma Capitals' list, which ranks the most challenging places to live with asthma. Researchers examined the 100 most populated metropolitan in the nation and took into account annual pollen scores, pollution levels, public smoking laws, poverty rates, and the percentage of people without health insurance. This year, Richmond, Virginia ranked number one. To see the complete list and learn more about this report, visit AAFA's website.

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