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Childhood asthma is a common and costly chronic medical condition, affecting 7 million children and leading to more than 50 billion dollars in direct healthcare costs every year.  It is particularly burdensome for non-Hispanic black and Puerto Rican children, who are four times as likely to visit the Emergency Department (ED) as non-Hispanic white children.  In this month’s issue of the Journal of Allergy and Clinical Immunology, Martin and colleagues review strategies to bridge care from the ED to home and ambulatory settings, like primary care providers ( J Allergy Clin Immunol 2016; 138(6): 1518-1525 ).   They divide these strategies into two domains: care coordination and self-management education. Five studies were identified regarding care coordination.  Three involved improved scheduling for follow up appointments, one involved allergen skin testing in the ED, and one involved use of a template to improve adherence to guidelines in the ED.  In all fi...

Asthma is a devastating chronic disease that affects up to 24 million Americans.  It is more severe and prevalent among African Americans and Hispanics, especially Puerto Ricans.  There’s a two-fold increase in asthma mortality in Hispanic children and three-fold among African Americans, compared to Whites.  The causes of these disparities are complex, but are undoubtedly worsened by the observation that they are less likely to be treated according to the National Asthma Education Prevention Program (NAEPP) guidelines, which have been widely available for the past 20 years.  To address these issues, the Patient-Centered Outcomes Research Institute (PCORI) funded 8 studies to help patients and clinicians adhere to the guidelines.  In this month’s issue of the Journal of Allergy and Clinical Immunology, Anise and colleagues review these 8 randomized control trials ( J Allergy Clin Immunol 2016; 138(6): 1503-1510 ). Among the approaches being used are (1) clinician...

Asthma is a huge public health problem in the United States today.  But all asthmatics are not affected equally – there are a lot of disparities in asthma care.  In this month’s issue of the Journal of Allergy and Clinical Immunology, Bryant-Stephens and colleagues describe the need for home visits to address these asthma health disparities ( J Allergy Clin Immunol 2016; 138(6): 1526-1530 ).  They note that most of the research on asthma so far has been on patients who go to clinics.  This has meant that people who have problems getting to the clinic, like the elderly, disabled, and those with other chronic conditions are often left out.  To help prevent overlooking these blindspots, they advocate for the involvement of community health workers.  In particular, they describe the experiences of three community health workers when they visited patients.  They found that the challenges at home are often overwhelming.  Social stressors in patients’ li...