USAsthma Summit 2024: Embracing Change and Innovation in Asthma Care
Oct. 30, 2024
Asthma management and treatment has changed a lot in the last decade. Through the years, Allergy & Asthma Network has focused on key issues such as new medications and expanding access to care to communities that are underserved.
These issues and more were in the spotlight on Oct. 25, 2024, at the 10th annual USAsthma Summit in Boston. The USAsthma Summit coincides with the American College of Allergy, Asthma & Immunology (ACAAI) Annual Scientific Meeting, also in Boston.
Speakers at the all-day Summit addressed:
- Clinical remission of asthma and what it means for patients
- How climate change is impacting asthma and allergic diseases
- Obesity-related asthma in children and adolescents
- How to use CDC EXHALE strategies to improve asthma care in under-resourced communities
- Racial and ethnic asthma disparities in maternal health
- Debunking asthma myths and misinformation
- Spirometry and race-neutral parameters in asthma care
- How parents and caregivers perceive oral corticosteroid use and biologics for asthma
“So much has changed in the past 10 years especially with respect to managing asthma,” says Allergy & Asthma Network CEO Lynda Mitchell. “The innovations in treatment have been life-changing and lifesaving for so many. Yet 10 people every day die from asthma in the United States, and that really hasn’t changed a whole lot. It’s really sad. We all know that asthma deaths are preventable with proper treatment and care. How can we change this? I think some of it has to do with patient education. That’s why we’re here today.”
More than 85 people attended the Summit in person. Nearly 400 joined the free interactive livestream.
The USAsthma Summit provides an up-to-date look at the state of asthma care in the United States. The Summit brings together…
The USAsthma Summit provides an up-to-date look at the state of asthma care in the United States. The Summit brings together…
- asthma coalitions
- state asthma programs
- physicians and other healthcare professionals
- school nurses
- community health workers
- people with asthma and their caregivers
- patient advocates
- key stakeholders in asthma care
Presenters advanced Guidelines-based asthma care. They discussed best practices and lessons learned from U.S. asthma programs. Patients and caregivers were in attendance. They shared their stories of living with asthma.
The Summit was moderated by Sherrina Gibson, Analytics Strategy Consultant with Allergy & Asthma Network.
“I’m here in a dual capacity as someone with both lived and professional experience with asthma,” Sherrina says. “I know what it’s like to feel powerless and scared. As a mother seeing my child struggle to breathe and being hospitalized after what was seemingly a simple cold, I’ve been fraught with unimaginable anxiety.
“Yet amidst all these challenges, I also see so much progress and so much hope. I have witnessed remarkable physical and mental health improvements in my child, once her asthma diagnosis and a treatment regimen were properly in place. Asthma remains a critical community health issue that needs to stay in the forefront of our efforts.”
The State of Asthma in the United States, Gailen Marshall, Jr., MD, PhD, FACAAI, President, ACAAI
Dr. Marshall talked about the challenges of treating asthma. As America has become more diverse, it’s important to understand how asthma affects people from different backgrounds, he said. He explained how viruses like COVID-19 and RSV add complications, making asthma harder to manage.
Dr. Marshall highlighted new advances in asthma care. Scientists continue to study the different types of asthma to create treatments that fit each person’s needs. Biologics are specially designed treatments to target asthma at the source of symptoms.
Dr. Marshall discussed the recent consensus statement on asthma remission adopted in December 2023. The statement was endorsed by ACAAI and other medical organizations.
“As more treatments become available, more patients are finding their symptoms are under control,” he said. “The consensus statement describes what asthma remission looks like.”
According to the consensus statement, the definition of clinical remission of asthma involves:
- no asthma attacks for 12 months;
- the absence of symptoms;
- stable lung function.
- no use of oral corticosteroids for at least 12 months;
This is a key topic for many allergists, Dr. Marshall said. The new definition of asthma remission could shape future treatment goals.
Climate Change and Asthma, Allison J. Burbank, MD, University of North Carolina at Chapel Hill
Dr. Burbank talked about how climate change is making asthma worse. Warmer weather and more carbon dioxide (CO2) in the air cause pollen seasons to start earlier, last longer, and make more pollen. Extra pollen and new types of mold can lead to stronger allergic reactions for people with asthma.
Climate change also raises air pollution, which makes asthma symptoms worse and leads to more hospital visits and lung infections, like pneumonia. Children are especially at risk because breathing polluted air when they’re young can harm their lungs and make asthma more likely.
Dr. Burbank highlighted how respiratory viruses are influenced by climate and extreme weather. Air pollution may increase the risk of respiratory viruses – a common asthma trigger – and induce more severe illness.
Dr. Burbank also said that communities of color are often affected more by climate change. They are more likely to live near heavy traffic or in areas that flood easily. They may have fewer resources to recover from extreme weather.
William Anderson, MD, Associate Professor of Pediatrics, Children’s Hospital Colorado and the University of Colorado School of Medicine
Dr. Anderson highlighted the unique challenges faced by children with both asthma and obesity. Obesity-related asthma presents differently from other types. Symptoms are driven more by metabolic issues and inflammation than by weight alone.
Dr. Anderson noted that children with obesity-related asthma often experience more intense symptoms. These include:
- prolonged coughing and wheezing
- increased mucus production
- nighttime breathing difficulties
- overall reduced quality of life
Overweight children have a higher risk of asthma flare-ups and longer hospital stays. In severe cases, they may require ventilation. Standard asthma treatments such as inhaled corticosteroids may be less effective in these cases.
Weight loss can improve asthma control and inflammation, Dr. Anderson said. It can also reduce the need to use a quick-relief inhaler.
Implementing CDC EXHALE Strategies through a Racial Equity Lens, Michelle Warner, MPH, Director, Asthma Prevention and Control Program, MA Department of Public Health
Michelle Warner addressed how the Massachusetts Department of Public Health (DPH) implemented CDC’s six EXHALE strategies. EXHALE is a set of six strategies from CDC’s National Asthma Control Program to help people with asthma achieve better health and improved quality of life:
- E = Education on Asthma Self-Management
- X = X-tinguishing smoking and exposure to secondhand smoke
- H = Home visits for trigger reduction and asthma self-management education
- A = Achievement of guidelines-based medical management
- L = Linkages and coordination of care across settings
- E = Environmental policies or best practices to reduce asthma triggers from indoor, outdoor, or occupational sources
DPH uses the EXHALE strategies to address health inequities involving asthma. “We found that inequities exist that make controlling asthma harder for individuals and communities of color,” Warner said.
Disparities in asthma outcomes are driven by factors such as social determinants of health and root causes, including:
- Racism and other forms of discrimination
- Poverty
- Unequal distribution of resources
DPH developed a Racial Equity Tool to focus on engagement and investment with communities of color. The Tool addresses the impact of social determinants of health in those communities. It also focuses on culturally appropriate healthcare and addressing language barriers.
“We identified 11 communities of focus, and these were communities that were bearing an inequitable burden of worse asthma outcomes,” Warner said. “We looked at not just asthma rates in these communities, but asthma-related emergency departments visits and hospitalizations, and other factors such as environmental justice designations. We made a commitment to center these communities in our work.”
Learn more on EXHALE and review resources for each strategy. Check out our National Asthma Resource Hub.
Patient Testimony: Mary White
Mary White, an asthma advocate and community health worker from Boston, shared her powerful journey with asthma. Living in public housing, she faced living conditions that impacted her asthma. Mold and pest issues triggered her symptoms.
“Being diagnosed with asthma was very scary,” Mary recalled. One afternoon, her condition became so severe that she could hardly breathe and was rushed to the hospital. As a mother, her concern grew even deeper because both her children also have asthma.
These experiences motivated Mary to work tirelessly to improve conditions for others. She supported healthy homes initiatives that focused on reducing asthma triggers in public housing. Common indoor triggers may include mold, pet dander, and pests including mice and cockroaches.
Mary encouraged healthcare providers to “meet patients where they are.” She emphasized the importance of listening to and understanding the unique needs of every individual. She urged providers to approach their work with empathy and collaboration.
“You must never look down on anyone. Never give up on them,” she told the audience. For Mary, the message was clear: supporting asthma patients requires a united effort.
Outdated Information and Asthma Myths: Setting the Record Straight, David Stukus, MD, Professor of Clinical Pediatrics and Director of the Food Allergy Treatment Center, Nationwide Children’s Hospital and Ohio State University College of Medicine
Dr. Stukus addressed some common myths and outdated information about asthma management. He emphasized the importance of healthcare professionals staying up to date on best practices for asthma care. Asthma care isn’t static, he said. People with asthma should expect their treatment needs to change over time as symptoms and circumstances evolve.
Dr. Stukus highlighted myths that can hinder effective asthma control. One is the belief that people with asthma shouldn’t exercise. On the contrary, people with asthma can and should stay active, as long as their symptoms are well-controlled.
Another misconception is that alternative therapies can treat asthma symptoms. He cited coffee, honey, or simply “walking it off” as misconceptions for treatment. Dr. Stukus stressed that medications like quick-relief albuterol are a necessary treatment for flare-ups. Home remedies are not replacements for asthma treatment.
He also debunked myths about managing asthma at home. For example, many people with pet allergies think they must get rid of their pet. Instead, prevention tips like keeping pets out of the bedroom may work. In addition, while air purifiers can help, they only improve air quality in one room at a time. So other actions may be necessary.
Outdated beliefs and misinformation prevent people from achieving the best possible asthma control, Dr. Stukus said. He encouraged healthcare providers and patients to stay informed. Fact-check and verify online health information with your doctor.
Spirometry and Race Neutral Parameters: The Impact on Communities of Color with Asthma, Eileen Wang, MD, MPH, Associate Professor, Division of Allergy and Clinical Immunology, National Jewish Health and University of Colorado School of Medicine
Dr. Wang discussed spirometry for asthma diagnosis and the importance of race-neutral lung tests. It can help improve care for people of color with asthma.
Spirometry tests measure how well a person’s lungs are working, but these tests can sometimes have race-based adjustments. These adjustments assume that people of different races have different lung capacities.
Dr. Wang explained that this can cause doctors to overlook serious lung problems in people of color. She said using race-based spirometry can make it harder for some patients to get the treatment and support they need. This includes certain asthma medicines or disability benefits.
Switching to race-neutral spirometry would provide a clearer picture of each patient’s true health, no matter their race. It would also give everyone a fairer chance at better care and asthma outcomes.
Dr. Wang emphasized that to create fairness in healthcare, we must address past and current injustices. She encouraged open discussions, transparency, and community outreach to build trust.
More research is also needed, especially studies that include people from different backgrounds. This can help doctors understand the full effects of these changes.
Racial and Ethnic Disparities in Maternal Health: How Asthma Disproportionately Affects African American and Hispanic/Latino Women, Juanita Mora, MD, Physician and CEO, Chicago Allergy Center
Dr. Mora spoke about the challenges that African American and Hispanic/Latino women with asthma face during pregnancy. About 7.7% of pregnancies in the United States are complicated by asthma, but rates are higher for Black women (10.8%) and Hispanic women (5.9%).
Dr. Mora explained these women are more likely to face serious risks like early labor, high blood pressure, and low birth weight for their babies. These risks are made worse by limited access to healthcare and the conditions in many neighborhoods.
Many African American and Hispanic/Latino women have a harder time getting quality asthma care. Lack of insurance coverage or under-insurance can limit their access to specialists. They are also more likely to live in areas with mold, pests and air pollution, which can make asthma worse.
Dr. Mora suggested solutions such as mobile asthma clinics and more interventions to reduce exposure to indoor mold and pests.
She also introduced Breathe4Baby, a new program that would connect allergists, lung specialists and OB/GYNs to support pregnant women with asthma. This program would improve communication between doctors, making sure women get the best care during pregnancy.
With new programs like Breathe4Baby and better access to asthma treatments, we can reduce asthma risks for African American and Hispanic/Latino mothers and help them have healthier pregnancies.
Oral Corticosteroids (OCS) and Biologics Perception: Results from a National Survey for Parents and Caregivers, De De Gardner, DrPh, RRT, FAARC, FCCP, Chief Research Officer, Allergy & Asthma Network
Dr. Gardner shared the results of an Allergy & Asthma Network national survey that examined how parents and caregivers feel about asthma treatments for children. It focused specifically on oral corticosteroids (OCS) and biologic medicines.
The study asked parents how much they knew about side effects of OCS. It also asked if they would consider using biologics for children with uncontrolled asthma.
The survey found that most parents think oral corticosteroids are safe as a treatment for asthma flare-ups. The parents expect doctors to prescribe OCS when a flare happens. Parents were familiar with short-term side effects of OCS, like mood changes, anxiety, trouble sleeping and weight gain. But they knew less about the long-term side effects.
Many parents expressed interest in biologic treatments. They believe biologics can help reduce the need for OCS and reduce the frequency of asthma flare-ups. However, they were concerned about the cost of biologics, both with and without insurance. Biologics are expensive medications, costing an average of $1,357 per month. This can make biologics hard for some families to afford.
The study showed that parents need more information about the long-term effects of OCS and the benefits and costs of biologics.
Allergy & Asthma Network is grateful to ACAAI for their support and the meeting space for the USAsthma Summit. We are also incredibly grateful to our corporate partners. Their sponsorship of the USAsthma Summit funded the program as well as the scholarships offered to in-person attendees.
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