Alaskans Addressing Asthma

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Alaskans Addressing Asthma

• The Alaska Asthma Summit and Coalition

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Who are we, how did we get here, and where are we
going?
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Background and Process

• CDC Asthma Control Program decided to address the
  growing public health concern of asthma by
  encouraging sustainable statewide Asthma
  Coalitions.
• In 2003 the American Lung Association of Alaska
  (ALA Alaska) and Asthma and Allergy Foundation of
  America- Alaska Chapter (AAFA-Alaska) were
  awarded funding to address asthma in Alaska.
• ALA Alaska decided to develop an Alaska Coalition
  and sponsor an Alaska Asthma Summit with the goal
  of developing an Alaska Asthma Plan.
• In Early 2004 the Alaska Coalition, a group of
  committed partners from diverse backgrounds who
  share the common goal of improving asthma care,
  was formed.

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Background and Process (cont)

• A Leadership Planning Team was identified and the
  process started in March, 2004 with the help of
  Suzanne Lagoni of Nexus Northwest, first leading
  to information gathering on asthma surveillance,
  stakeholders, opportunities, barriers, and
  outcomes.
• At a retreat in April, 2004 this information was
  reviewed and the current working Task Forces on
  surveillance, scientific interventions,
  partnering and training, school based programs,
  and work-based asthma were formed and plans for
  the Summit finalized. The Task Forces began to
  work on goals.
• Members of each Task Force will shortly make
  brief presentations on work to date and then your
  work begins.

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Background and Process (cont)

• You, the Delegates to the Summit, were selected
  from the diversity of Alaska. (You are parents
  and patients with asthma, individuals with rural
  and urban, native and non-native backgrounds,
  health care providers, planners, and payors both
  public and private, marketing and pharmaceutical
  representatives, business owners, educators, and
  politicians)
• You will join us in the Task Force break out
  session of your choice. There an evaluation of
  the goals of each Task Force and a discussion of
  the objectives needed to achieve the goals will
  occur. Following todays breakout session we
  gather as a group for very brief reports of the
  progress.
• Tomorrow we continue work in breakout sessions to
  develop goals and objectives and produce a plan
  outlining our Task Force's necessary actions,
  responsibilities, resources, time course of
  action, and measurements of objectives.

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Summit objectives

• Produce a draft Alaska State Asthma Plan to
  address asthma in Alaska
• Expanded Task Forces working on specific goals
  identified by the Alaska State Asthma Plan
• An expanded Alaska Asthma Coalition to help
  implement the Plan

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The Alaska Asthma Summit and Coalition

• The United States is experiencing what has been
  described as an asthma epidemic leading to
  unprecedented levels of death and morbidity at a
  time when our level of understanding of asthma
  and our treatment options have never been better.
• Alaska needs to define its asthma burden and to
  develop an Alaska State Asthma Plan to reduce
  this burden.

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You want motivational thinking?

• We need your ideas, energy, talent, business and
  personal contacts to improve care and outcomes
  for asthma.
• As we move into smaller working groups keep in
  mind that we can do it, we can improve care,
  access, and cost for asthma, we just need to want
  to do it bad enough.

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You want REALLY LARGE thinking?

• This summit is about asthma but at the same time
  it is about something more-opportunity- the
  opportunity to change health care.
• If you are unhappy about health care costs,
  health care access, health care education
  (knowledge), health insurance (public and
  private), this is your opportunity to begin to
  change the status quo.
• Could our efforts demonstrate a better way to
  provide care for all chronic disease (obesity,
  diabetes, arthritis)?
• Could we stimulate development of a better
  national health care model?

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What do we know about asthma?

• According to the Global Burden of Asthma Report,
  May 4, 2004, 1 in 10 North Americans has asthma.
• Inhaled corticosteroids are the best preventative
  treatment, are safe, and when combined with a
  long acting bronchodilator have been shown to
  allow guideline defined asthma control in
  majority of patients (the recommended treatment
  is safe and effective)
• For those with allergic asthma uncontrolled by
  corticosteroids and add on therapy we have safe
  and effective, but expensive treatment

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What do we know about asthma?

• Environmental control used appropriately can
  improve asthma but many patients use
  environmental control inappropriately
• The majority of costs are driven by a minority of
  patients who are not necessarily the most severe
• Medication, emergency room care, and
  hospitalization are the major components of
  asthma cost and we know with appropriate care
  ER and hospital costs can be minimalized

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What do we know about asthma?

• Patients and providers generally under treat
  asthma
• Patients in general are non-compliant
• cost, fear, beliefs, lack of education,
  complexity of illness, confusion
• The most dangerous and most expensive asthma is
  poorly treated asthma

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To summarize What do we know about asthma?

• There is a disconnect between patients with
  asthma and safe, effective treatment.

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Scientific Interventions Task Force

• Members Larry Taylor, Terry Babb, Thad Woodard
• Goal 1 Improve asthma awareness of public and
  health care professionals
• Is this important?
• Will this improve asthma outcomes in Alaska?
• For which methods do we have evidence of
  effectiveness?
• Will any of these methods be effective in Alaska?

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Scientific Interventions Task Force

• Goal 2 Research evidence based asthma disease
  management models appropriate for Alaska
• Can asthma in Alaska be managed better?
• What evidence based models for asthma care are
  there?
• traditional
• disease management by specialist
• school based
• combinations
• Can evidence based models be successful in
  Alaska?
• Is a new model needed?

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Gather information

• The Leadership Team and Task Forces have begun
  the information gathering
• This Summit serves to gather additional
  information from a more diverse prospective while
  at the same time increasing awareness of the
  asthma problem, and building a larger coalition
  to help sustain efforts to complete our goal.

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Problem solving 101

• Define the problem
• Gather information
• Assess the information
• Generate solutions
• Act
• Review