Research seeks improved treatment for children with asthma

Thousands of children living with asthma in Chicago could benefit from a new multi-center study led by UI Health researchers.

The study, funded by a $4 million, three-year contract from the Patient-Centered Outcomes Research Institute, is aimed at improving treatment for uncontrolled asthma in children.

Rates of asthma in children are unusually high in Chicago, and the respiratory disorder disproportionately affects African-American children.

“Children with asthma are frequent visitors to emergency departments,” said Jerry Krishnan, associate vice president for population health sciences at UI Health and principal investigator for the study, called the CHICAGO Trial (Coordinated Healthcare Interventions for Childhood Asthma Gaps in Outcomes).

“There are gaps in our understanding about how best to implement asthma guidelines in the emergency department. The CHICAGO Trial was designed specifically to address gaps in the care of children.”

Researchers at eight medical centers in Chicago — UI Health, Sinai, Lurie Children’s Hospital, University of Chicago, Rush University, Stroger, NorthShore and Northwestern University — will consider the effectiveness of two interventions among 640 children ages 5 to 11 who come to the ER with uncontrolled asthma.

One intervention gives emergency physicians decision-support tools to help them follow established guidelines for prescribing oral and inhaled corticosteroids and faster-acting “rescue” medications. Patients and their parents or guardians receive guidance on how to self-manage asthma and arrange for follow-up with a primary care provider.

The second intervention includes visits to the child’s home by a community health worker, to help the family reduce environmental asthma triggers.

“Many homes contain asthma triggers that patients don’t know about, or don’t know how to avoid,” Krishnan said.

“Having a trained community health care worker come to the home, identify triggers and help the family avoid these triggers can have a great impact on children’s asthma.”

The community health workers will provide individualized education on asthma self-management and work closely with the child’s outpatient asthma care provider.

The success of the interventions will be measured through interviews with the children’s caregivers. It will focus on outcomes meaningful to children — such as not missing school and being able to participate in sports — and meaningful to caregivers and families, such as lower anxiety and not having to miss work.

Partners in the trial are the Respiratory Health Association, Chicago Asthma Consortium, the City of Chicago Department of Public Health, the IIT Institute of Design, Illinois Emergency Department Asthma Surveillance Program and the NIH/NCATS Clinical and Translational Science Award Chicago Consortium.

Other investigators from UI Health include Michael Berbaum, director of the Methodology Research Core, Institute for Health Research and Policy; Sharmilee Nyenhuis, assistant professor of pulmonary, critical care, sleep and allergy; Trevonne Thompson, assistant professor of emergency medicine; and Harsha Kumar, assistant professor of clinical pediatrics.