Child Hospitalizations for Asthma Peak in September

During the fall, especially September, the number of hospitalizations due to asthma peaks in Minnesota. This pattern has been consistent since 1998, the earliest year for which MDH has data on asthma hospitalization trends. Other states, including Michigan, Vermont, New Hampshire, and Nebraska, have reported similar patterns.

The most distinct peaks in September occur in children, with pre-school children having the highest rates of asthma hospitalizations. School-age children, including young teenagers, have the second highest rates in September, while older age groups exhibit less seasonal variation. Though there is no single, proven reason for this peak, it is believed to be influenced by respiratory infections and increased pollen and mold counts.

Data source: Minnesota Hospital Association

Parents of children with asthma can do many things to prevent hospitalizations:

• Schedule a "well-asthma" visit with their child's health care provider to review their asthma management plan.

• Obtain an up-to-date Asthma Action Plan from the child's health care provider and give copies to the school nurse and/or day care provider.

• Make sure the child has asthma rescue medications, holding chambers, and peak flow meters for home and school.

• Make sure the child has access to his/her asthma medications and knows how to use them.

• Minimize the child's exposure to things that trigger asthma, such as dust mites, secondhand smoke, mold, and pet dander.

• Schedule a flu-shot appointment with the child's health care provider when the vaccine is available.

The Minnesota Department of Health is working with health care providers across the state to support good asthma management year round. By working together, families and health care providers can help minimize the possibility that children will need to be hospitalized for asthma attacks.

For more information, call the Minnesota Department of Health Asthma Program at 612-676-5226. Visit our Web site at http://www.health.state.mn.us/divs/hpcd/cdee/asthma/Documents.html for the news release, fact sheets, educational materials, Asthma Action Plans, and other resources.

FREE "Tobacco-Free Sports" Posters Available!

Tobacco-Free Youth Recreation (TFYR), the Minnesota Department of Health, and the Minnesota Prevention Resource Center (MPRC) have partnered to make tobacco-free sports posters available to Minnesota residents for FREE! All you pay for is the shipping cost. Quantities are limited! Download the order form at: http://www.ansrmn.org/TFYR03Home.htm.

Available posters include:

1. Minnesota Twins "Be Tobacco Free: Choose Not to Chew" featuring centerfielder Torii Hunter

2. Minnesota Thunder "Fast, Fearless, Strong, and Tobacco Free" featuring players Johnny Menyongar, Joe Warren, & Freddy Juarez

3. Minnesota Wild "Our Only Addiction is the Game" featuring players Brad Bombardir and Wes Walz

4. University of Minnesota Gophers "Tobacco-Free is the Way to Be" poster featuring 10 athletes. (The Gophers poster must be ordered separately from TFYR at tfyr@ansrmn.org or 651-646-3005. Please indicate quantity of posters requested and shipping address.)

Sports-related tobacco prevention posters can be placed in school classrooms, locker rooms, gymnasiums, community centers, ice arenas, and other community venues.

FREE Asthma Health Fair and Screening!

Adults and children who experience breathing problems, such as coughing, wheezing and shortness of breath, can find out if asthma is "taking their breath away" through the Nationwide Asthma Screening program. The screenings will be conducted by doctors, nurses and respiratory therapists from the Twin Cities specializing in asthma. Those who already know they have asthma can talk with a specialist about their asthma and how to keep symptoms under control.

Date: Saturday, October 29, 2005

Time: 9:00 - 2:00 p.m.

Location: Minneapolis Urban League, 2100 Plymouth Avenue North, Minneapolis

Contact Person: Sally Smaida 651-222-2477 @ sally.smaida@mnpca.org or Makeda Norris 612-302-3164 @ mnorris@mul.org

This is brought to you locally by the Metro Minnesota Asthma Coalition and the Minneapolis Urban League.

How it Works?

During the screening, adults and children who are experiencing breathing problems will answer some questions about their breathing problems. Another version of the questions is available for parents of children up to age 8 to complete on their child's behalf. In addition to the questions, participants take a special lung function test that involves blowing into a tube and then meet with a physician to determine if they should seek further examination and diagnosis.

The Nationwide Asthma Screening Program has been developed in cooperation with two patient support organizations: the Asthma and Allergy Foundation of America and the Allergy and Asthma Network/Mothers of Asthmatics.

The Interactive Asthma Action Plan (IAAP) in Action!

by Kathy Thielen, RN, Duluth Family Practice Center

Have you ever worked with an asthma patient who keeps going to the ER? An asthma child who has frequent hospital admissions? How about the asthma patients who use their inhalers upside down?

When our facility began using the IAAP in December 2003, it forced us to look at all aspects of asthma care. Our family practice residency program consists of 32 resident physicians and five faculty physicians. After the initial IAAP inservice and live demonstration of the IAAP and Spirometry to all providers, we focused on our main goals:

• create and provide an asthma action plan (AAP) to our pediatric population ages 5-18

• broaden this goal to provide AAPs to all of our asthma patients

• create a one to one patient to resident/RN asthma teaching ratio (so we can find those patients who use their inhalers upside down!)

• provide peak flow meters to all asthma patients (provided free by a
  drug rep/grant)

• provide American Academy of Family Physicians (AAFP) asthma brochure and patient education materials on peak flow instructions/calendar, use of metered dose inhalers (MDI's), and use of dry powder inhalers (DPI's)

• use "Spirocard" spirometry testing via a software program on a designated laptop

• have RN work one to one with each physician the first time using the IAAP to walk them through the process

The IAAP is accessed through an icon on a computer by the physician. The IAAP is printed in color and given to the patient. A copy is made to be scanned into the patient's electronic medical record (EMR). Parents have the option of checking boxes on the IAAP for daycare or school so they may have a copy.

The IAAP is a wonderful teaching tool and works well in our residency program. If physicians are not sure how to classify the severity of a patient's asthma, the IAAP helps them choose the classification based on the patient's symptoms. Once classified, the medication choices follow the recommendations for the severity classification chosen. We have found that if a physician wants to choose an unlisted medication, then the national asthma guidelines are not being followed!

MDH was very helpful the few times we needed to call/email them with questions during the initial set-up. Using email for questions has worked well.

While we continually work on our asthma goals, we feel the IAAP has been a great asset. If you need a tool to help with your asthma patients, consider the IAAP! The IAAP can be found online at http://www.health.state.mn.us/divs/hpcd/cdee/asthma/ActionPlan.html or https://www.mnasthma.org/aap/.

EPA Intervention Grant

The MDH Asthma Program and Pediatric Home Service are collaborating to implement environmental interventions for asthma triggers such as secondhand smoke, house dust mites, mold, and animal dander. Funding is provided by a U.S. Environmental Protection Agency (EPA) grant.

Fifty children have been recruited into the study as of June 30, 2005. The most common product interventions have been air cleaners, bed and pillow encasements, and vacuum cleaners; the average cost for these interventions was $225.

Preliminary results from the initial 50 interviews include: 38 children have written asthma action plans; 27 missed three or more school days during the previous 90 days. Forty six percent of the children live in a home where smoking is permitted. See the table below for some of the common triggers and allergies reported.

Follow-up interviews are planned for 3, 6, 9 and 12 months after the environmental interventions. For additional information on the EPA grant, contact Laura Oatman at 612-676-5049 or laura.oatman@health.state.mn.us.

Welcome to our New Metro Minnesota Asthma Coalition Coordinator!

Please welcome Sally Smaida as the new Metro Minnesota Asthma Coalition Coordinator. Sally has her MPH in public health administration from the University of Minnesota School of Public Health. Sally comes to the Minnesota Asthma Coalition with a variety of public health experience in non-profit, academic, corporate, and government settings where she worked on policy, planning, and advocacy. Most recently, she was the Director of Public Policy at the Minnesota Association of Community Health Centers. Sally can be reached at 651-222-2477 or sally.smaida@mnpca

Join us for Super Asthma Saturday!

This fun-filled educational event is for anyone and everyone who has asthma. Dr. Amy Ellingson will give an asthma presentation. There will be educational games for children and three different asthma education stations: Inhaler/Nebulizer use, Peak flow use/Asthma control, and Environmental triggers.

Sponsored by the West Central Regional Asthma Coalition (WCRAC) in association with local public health providers.

Date: September 17, 2005

Time: 10:00 a.m. until 12 noon

Location: Discovery Middle School, 510 North McKay, Alexandria, MN 56308

Contact Person: Doreen Hanson, WCRAC Coordinator @ 320-763-6018 or doreen.hanson@mail.co.douglas.mn.us