Asthma had Toni Saunders at her wits end. Her 2-year-old son Dahomey had been to the doctor or the emergency room 10 times in little more than a week with persistent asthma attacks. The frequency of their medical visits prompted a call from her provider, Optima Health Plan, and their asthma management program.
"It made me feel good to know somebody else was paying attention," Toni says. Optima arranged for a visit from a Sentara Home Care
nurse, who did an assessment and made some recommendations for controlling Dahomeys asthma.
"She said to remove some of his stuffed animals," Toni remembers. "He had so many he didn't even miss them. She also said to put an allergy cover on his mattress."
"Between those things and the allergy medicine the doctor prescribed, it had an effect," Toni says. "Then, she called back a while later to see how he was doing, and she's available any time I need to talk with her. Thats a comfort to me," Toni says.
Thanks to the preventive health care offered to Dahomey Saunders and hundreds of asthma patients like him, Optima Health has received a first-ever award for asthma management from the U.S. Environmental Protection Agency (EPA). The National Environmental Leadership Award in Asthma Management recognizes Optima's innovative seven-year program to control environmental factors in patients homes that trigger asthma attacks. Children's Mercy Hospital of Kansas City also received an award.
"Asthma symptoms can often be tied to allergies," says Janis Sabol, asthma program coordinator for Optima Health. "Controlling household allergens and optimal use of medications can prevent asthma attacks."
For Toni Saunders, that includes watching pollen levels when Dahomeys seasonal allergies act up, and limiting how much he runs around outdoors.
"Home Care gave me a book about asthma geared for children. We went through it with his twin and the two older kids, so they can help with him, too," Toni says. Home Health teams identify asthma factors
Optima Health teams with Sentara Home Health Care to make the asthma management program work. Nurses and respiratory therapists visit the homes of high-risk patients to identify environmental factors that aggravate asthma symptoms. Those factors include pet dander, dirty carpets, dust, mold and cockroach infestations. The Home Health team gives advice on how to control those factors, whether its keeping animals out of bedrooms, reducing the use of pesticide sprays, removing old carpets or repairing leaky roofs.
Despite growing knowledge of environmental factors as asthma triggers, a recent national survey by EPA found that less than 30% of asthma patients are taking all the recommended steps to reduce exposure and limit preventable asthma attacks.
"Prevention is the best medicine," says Janis Sabol of Optima. "After a pilot study with 50 high-risk children, Optima concluded it was better for patients, and better for business, to manage asthma rather than just treat the symptoms. More adults than children have asthma
"Asthma is not just a childrens disease," says George Heuser, M.D., medical director for Optima Health. "Children get most of the attention, but far more adults than children suffer from asthma." Heuser adds, "5,000 Americans die from asthma each year, but 95% of those deaths are preventable."
"We try to prevent asthma symptoms for our most vulnerable patients by controlling the environmental factors that cause them," Heuser adds, "and were delighted that EPA recognized the benefit of our program for patients." Optima program reduces hospital visits, expense
"About 10,000 of our Optima members have asthma," Janis Sabol says, "but less than 6%, or about 500 patients are at such high risk that they are eligible for our environmental management program." Optima identifies the highest-risk patients by monitoring their frequency of doctor visits and hospitalizations. Data gathered over six-and-a-half years showed a savings to Optima of $300,000 through cost avoidance for emergency department visits and hospital admissions. "On the other hand," Sabol continues, "medication costs increased somewhat, but thats okay, because we managed the disease better and patients spent less time at the doctors office or the hospital." EPA recognizes Optima for pace-setting program
"The health care community can make significant contributions to the quality of life of millions of people living with asthma by educating patients about the environmental irritants and allergens that can trigger their attacks," says Tom Kelly, U.S. EPA Indoor Environments Division Director. " EPA congratulates Optima Health for their innovative approaches to environmental asthma management and treatment programs." Asthma Management Tips from EPA
Smoke outside - Second hand smoke is a major asthma trigger.
Control mites - Cover mattresses and pillows with allergy-control zippered covers. Wash bedding weekly in hot water.
Watch ozone levels - If Air Quality Index (AQI) reaches unhealthy levels, limit outdoor activity.
Dust and vacuum regularly - Dust with a damp cloth and vacuum carpets and upholstered furniture.
Control pet dander - Keep pets outside or limit their access to living/sleeping areas.
Control cockroaches - Infestations can trigger asthma attacks. Clean up spills promptly. Remove kitchen garbage from house. Store food in airtight containers.
Limit pesticide sprays - Use baits or traps where possible. Ventilate rooms where spray is used. Stay out of sprayed room for several hours.
Break the mold - Mold and mildew are asthma triggers. Replace moldy ceiling tiles plaster and carpeting. Fix leaky roofs and pipes.
Air it out - Use exhaust fans or open windows when cooking or showering to reduce moisture.
Plan ahead - Write a customized asthma attack response plan with your health care provider that includes known triggers, ways to control them, and best responses to an attack.
Share these tips with day care providers, coaches, teachers, etc.