Castle Medical Center - Expert Asthma Patient Training Program

Overview

The renovation of Castle Medical Center’s (CMC’s) Emergency Department (ED) a few years ago included adding “asthma chairs” – comfortable recliners – for the treatment of asthma patients. At that time, a unique asthma education program was developed to help prevent repeat admissions for severe asthma patients. The medical center’s Expert Asthma Patient Training Program is the first program in the United States that trains asthma patients about getting asthma diagnosed, following their physicians’ treatment plan, and successfully managing this serious condition. Once patients complete training, they may become certified through the state’s Hawaii Asthma Initiative (HAI) to teach family, friends, and those in the community what they’ve learned about asthma and its management.

Impact

The HAI, a broad-based, multi-organizational, statewide community collaborative, supported the Individual/Family/Community Workgroup that recognized gaps in asthma education in the state of Hawaii. It provided the curriculum and certification for training expert asthma patients to supplement existing professional asthma educators to help fill gaps in asthma education. Moderate to severe asthma patients who manage their disease well are identified and asked to become an expert asthma patient trainer. If they agree, they take a curriculum that consists of two two-hour sessions, and pre- and post-testing to ensure that their knowledge is accurate. Currently, the training is done at CMC but has the potential to be held in multiple venues across the state.

This program is very new and statistics are not yet available. Although CMC does not have data to support a reduction in ED visits, feedback from the expert asthma patient trainers illustrates how the program has filled the gaps in asthma education:

“My sister-in-law and her children have asthma. She was prescribed Advair twice a day. However, she was not consistently taking her inhaler. It was only after I explained the differences between her rescue and long-acting inhaler that she understood the difference and importance of taking her medicine as directed. Her physician probably explained this to her, but it took my reinforcement to get her attention because I also have asthma. It also helped that I am on Advair and that my asthma is under control. That’s the power of the Expert Asthma Patient Program. People with asthma tend to believe others with asthma versus someone who just read books on asthma.”

“There was a girl in my son’s class who started coughing. I recognized the cough and started talking to her mother. Based on my suggestion, she took her daughter to the doctor that day. The following day she thanked me. Her daughter was having problems breathing, but she thought it was just a cough. She was treated and is doing better.”

“I found the program very beneficial and even recommended that two friends go through the training.”

“When my kids show signs of problems with breathing, I can manage it at home and determine whether or not it requires a visit to the doctor.”

Challenges/success factors

The program is successful in that we now have people in the community who are actually helping other patients with asthma. These expert asthma patient trainers have been empowered to talk to their family and friends about how they can manage their asthma. The challenge is that some of the patient trainers have not yet taken the initiative to use their skills in the community. We are in the process of contacting them to offer support so that they feel empowered and comfortable training others. Japanese physicians that were visiting CMC’s asthma education program were so impressed with the program that they began training and certifying expert asthma patient trainers at their facility in Japan.

Future direction/sustainability

Approximately 20 trainers have been trained statewide. The next step is to encourage and support them so that they can produce other trainers.

Advice to others

The curriculum is available through the Hawaii Asthma Initiative or through CMC. We would be happy to provide the entire package.

Contact: Ron Sanderson, RRT, Med, DrPH, AE-C
Director of Cardiopulmonary
Telephone: 808-263-5183
E-mail: Sanderrr@ah.org