An Interview with Tonya Winders, CEO
What do you see as the greatest challenges to professionals working in asthma care today?
Unfortunately, our fragmented, complex healthcare system makes it challenging to spend the time needed with patients and provide the optimal level of care. The new patient paradigm is that they think and behave with more of a consumer mindset than a traditional patient attitude toward care. This often results in choosing “the best healthcare I can afford” instead of the best healthcare options based on needs, preferences, values, and strong scientific evidence.
What would you like people to know about the Network?
The Allergy & Asthma Network has been focused on one mission since 1985—ending needless death and suffering due to asthma, allergies and related conditions through outreach, education, advocacy and research. We are here to support not only the families throughout their journey while living with these conditions, but also the healthcare professionals who are dedicated to their care.
How can practitioners most effectively assess a patient’s asthma?
Asthma should be assessed using objective tools like spirometry, fractional exhaled nitric oxide, blood eosinophils, and measuring total immunoglobulin E (IgE), an antibody that is naturally produced by B cell lymphocytes and may signal high risk for asthma attacks.
Additionally, tools like the Asthma Control Test, Severity Assessment Tool, and Shared Decision Making Tool are helpful to better understand a patient’s condition and foster a more effective patient-physician partnership.
How can healthcare practitioners work with patients to help them understand what good asthma control is and recognize their own status?
It is important to ask patients, “What matters most to you in managing your asthma?” or “What is asthma keeping you from doing that you would like to do?” Answers to these questions change the discussion and allow patients to be more open about the struggles they are facing.
What issues do you think are most important to patients?
The fact that fewer than 30 percent of asthma patients are adherent to their treatment regimen suggests they are very confused and dissatisfied by their therapy. Often it’s as simple as patients not understanding why it is important to take their controller, even when they are symptom free. Studies show that more than 70 percent do not use their inhalers correctly, so it becomes important to review refill records and have patients demonstrate how they use their inhaler at every visit to keep them on track with their medications. We need to be more accepting of non-adherence have more trusting dialogues with patients in order to resolve these issues and get them on a treatment they will endorse and adhere to.
What is the role of corticosteroids in quality asthma care?
Inhaled corticosteroids are the mainstay of controller medications for those living with asthma. They are essential to control inflammation in the airways and reduce the symptoms patients experience. Oral steroids are often given during an asthma flare or exacerbation. While oral steroids are inexpensive and effective in the short term to reduce symptoms, they have significant side effects over the long run, including mood and sleep disturbances, weight gain, diabetes, osteoporosis and glaucoma. This is why we recommend patients seek an asthma specialist if they take two or more bursts of oral steroids in a 12-month period. It may be time to step up controller medication or consider the targeted therapies now available for severe asthma.
How do you decide what programs and resources to include on the Network?
The Allergy & Asthma Network develops guidelines-based, patient-friendly educational resources that are reviewed by board-certified allergists and pulmonologists. We tailor our resources to each step of a patient’s journey from newly-diagnosed to those living long-term with a chronic disease. We focus on a sixth-grade health literacy level to all patient materials and also offer many bilingual tools in English and Spanish. Our healthcare provider educational resources are created based on the demand of members in our community. From monthly webinars to posters to our online learning management system, we take pride in all educational resources taking a patient-centered approach to building effective collaborative care teams.
What’s next for the Network?
Two exciting programs coming in 2019 include our Telehealth Platform with Asthma Coaches to provide virtual visits, and our Oral Steroid Stewardship campaign, which will reinforce the appropriate use of oral steroids in asthma and raise awareness among patients, providers, payers, and policymakers.
Last updated on 9/22/19.