Opening a new ‘chapter’ on pediatric asthma, allergy and anaphylaxis

Living with allergies can be challenging, especially for children, but if patients follow simple measures they can stay safe and healthy. Food allergy management strategies, including prevention and emergency preparedness, need to be maintained at all times. Additionally, food allergens need to be avoided and allergic emergencies need to be recognized and treated with epinephrine.

Once learned, these pillars of management help keep children with food allergies safe and having a food allergy becomes completely manageable. Without these pillars of management, there is increased risk for allergic reactions and increased risk of fatal allergic reactions. A patient’s health care team needs to teach these pillars upfront at the time of diagnosis.

Pediatricians on the front line

As they are frequently the first of the health care team to hear of allergic reactions, pediatricians are on the front line. A recent Asthma & Allergy Foundation of America study, “Anaphylaxis in America,” demonstrated that among patients who experienced anaphylaxis, half were never written a prescription for epinephrine and 38% planned to treat with epinephrine for future anaphylaxis.

The physician arm of the study demonstrates an unmet need in physician education, including pediatricians (Altman, et. al., Anaphylaxis in America: A national physician survey, J Allergy Clin Immunol, 2014). The food allergy and medical communities have struggled with how best to address this need: How do we educate pediatricians more effectively so they can educate their patients and families more effectively?

Introducing Chapter Champions Program

In March 2014, Allergy & Asthma Network partnered with the American Academy of Pediatrics to reach pediatricians. The Medical Home Chapter Champions Program is a collaborative effort designed to create champions in allergy and asthma care that can educate and advocate throughout their regions and locales. This educational and advocacy initiative is a way to disseminate needed information to help care for families with allergies and asthma and to provide the infrastructure for collaborations between pediatricians, allergists, and other stakeholders.

This important initiative exists to achieve the following key objectives:

To improve outcomes for all children with asthma, allergy and anaphylaxis through comprehensive team-based family-centered care and effective co-management between primary and subspecialty care settings.

To achieve this goal, the project will: support a successful, national chapter champions network model; initiate a team-based, care coordination and co-management quality improvement effort; and cultivate an enhanced focus on advocacy and policy.

The Chapter Champions program is expected to serve as a conduit for disseminating best policies and practices to pediatric health care providers nationwide through the leadership and networks of AAP chapters, as well as provide advocates for change at the local, state, and national levels. In addition, Chapter Champions will become involved in providing technical assistance, as well as tools and resources to pediatricians and other pediatric health care providers; and assist in aligning national and state, local and/or community priorities.

Using both a Web-based learning initiative and a quality improvement learning collaborative approach, Chapter Champions will develop, enhance and test tools that support the interface between primary care pediatricians and pediatric subspecialists in team-based provision of asthma, allergy and anaphylaxis care. An additional goal of this component of the project will be to optimize the role of the primary care physician while ensuring appropriate referrals to subspecialists.

The Chapter Champions program is intended to advance policy change that supports implementation of family-centered asthma, allergy and anaphylaxis care at the community, chapter and state levels through the provision of educational and other materials and support for cross-sector collaboration.

Epidemiology, Diagnosis and Management in the Medical Home

On January 27, 2015, Champions were educated on guideline-based care for food allergy. The webinar, “Food Allergy: Epidemiology, Diagnosis and Management in the Medical Home” is freely available for viewing along with the supporting slides.

Future projects include live and Web-based learning initiatives dedicated to sharing best practices in care from Champions across the country. Furthermore, AAP & Allergy & Asthma Network are planning a Networking and Educational Conference for Chapter Champions in late 2015.

The Allergy & Asthma Network is also planning a 35-city educational tour aimed at building collaborative care teams throughout the US. Participants at these events will include school nurses, primary care providers, pediatricians, pharmacists, subspecialists, patients and caregivers. We will focus on interactive case discussions and encourage open dialogue to empower communities, effectively overcoming barriers and improving health outcomes.

To learn more about Allergy & Asthma Network visit www.aanma.org/.

To learn more about AAP Medical Home Chapter Champions visit: http://www.aap.org/en-us/professional-resources/practice-support/medicalhome/Pages/Asthma-Allergy-and-Anaphylaxis.aspx