Community Connection Newsletter

Summer, 2011

Inside Story:
The Asthma Crisis in Our Own Backyard

Providing Solutions and Reaching Patients, One by One

Asthma has been on the rise for 30 years, and it’s become especially common in this region. In fact, 16.6 percent of people in Alameda County will develop asthma, compared with 13.6 percent of Californians generally. And some areas have been particularly hard-hit. The asthma rate in Oakland, for example, is 62 percent higher than the county average.

Asthma can usually be controlled, but if you don’t have access to medication or don’t know how to use it, things get worse, and you can end up in the Emergency Department (ED). Oakland and Hayward have especially high rates of asthma ED visits—31 and 29 percent higher, respectively, than the county average.

Alta Bates Summit Medical Center wants to bring those numbers down. Through its Asthma Resource Center, the hospital reaches out to people in the community to give them the support they need before their asthma becomes an emergency. Prompted by community data, Alta Bates Summit developed an initiative to help ED patients learn to manage their asthma. “If someone is in the ED with asthma problems, it’s usually a system failure,” says Laurel Olslund, R.N., a respiratory therapist and certified asthma educator with the hospital’s Asthma Resource Center. “We call at-risk patients who’ve been in the ED with asthma or bronchospasm and invite them to come in and learn more about asthma. When they do, we explain how to take their medicines because the medication routine can be complex. We give these patients a free spacer tube, an effective way of delivering medication, and a free peak flow meter, which helps them determine when they’re in trouble. We also pay for their asthma medication for the first month.” Thereafter, patients can call a dedicated pager number whenever they have a question—whether about medication, symptoms or to find an area clinic that would best serve their needs.

Since the program launched in 2001, asthma-related ED visits have dropped by 58 percent, and hospital admissions have dropped by 46 percent—45 percent among the medical center’s target population of underserved patients.

Because asthma is now the most common health condition among children in California, another important initiative, Oakland–Berkeley Community Action to Fight Asthma, was launched in 2002 to initiate asthma programs and policies in local schools. The project was founded by the hospital’s Ethnic Health Institute (EHI).

“The project was part of a statewide initiative funded by the California Endowment to address asthma triggers where children live, work and play,” says Mindy Landmark, Community Benefit Program coordinator at Alta Bates Summit. Mindy and her team provided asthma education to students, teachers and parents, and also worked with the Oakland Unified School District to develop policies and practices that support kids in managing their asthma.

EHI’s Asthma Committee has also been working hard to reach ethnic and racial groups that are most at risk. African-Americans have the highest asthma prevalence of all racial groups—1.7 times that of Asian-Pacific Islanders, who have the lowest prevalence. To raise awareness, the Committee conducts health fairs and other community outreach.

It’s all part of Alta Bates Summit’s strategy to attack asthma from every angle. As Mindy says, “It takes everyone working together to support the needs of the community and address both the medical management of asthma and the environmental triggers.”

For more information about asthma services at Alta Bates Summit, call 510-204-1586.

Breakthrough Treatment for Severe Asthma

People with severe, persistent asthma—about 10 percent of cases—find it very difficult to manage, even with medication. That is, until now.

Alta Bates Summit is one of only 22 centers in the country that offers a groundbreaking new procedure, called bronchial thermoplasty, that may finally reduce symptoms like shortness of breath, coughing and wheezing in adults with severe asthma.

The procedure has resulted in a 32 percent reduction in asthma attacks; a 66 percent reduction in days lost from school, work or other activities; a 73 percent reduction in hospitalizations; and an 84 percent reduction in Emergency Department visits.

“Patients still have asthma after the treatment and need to be on their maintenance medication, but they may be on a lower dose and they might not need to depend on steroids like prednisone,” says Andrew McClintock Greenberg, M.D., Ph.D., a pulmonologist at Alta Bates Summit.


Andrew McClintock Greenberg, M.D., Ph.D.

How does it work? Persistent asthma symptoms are caused by constriction of the smooth muscle tissue that surrounds the airways, which restricts airflow. Bronchial thermoplasty is performed through a bronchoscope to apply thermal energy—heat energy—to the smooth muscle throughout the airways, reducing its bulk and opening the airways.

This outpatient procedure, which is performed using either moderate sedation or general anesthesia, takes 30 to 45 minutes. The procedure is done over three sessions, with about three weeks between sessions. Some patients may experience a temporary asthma flare-up after the procedure.

For those with severe asthma, bronchial thermoplasty is an exciting option. As Dr. Greenberg says, “This is the first nonmedication treatment for asthma, and I think that’s a significant breakthrough.”

For more information, call 510-204-6090 or learn more about bronchial thermoplasty on our website.