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Special Edition, 2011

GIP in Focus

Bridging the Asthma Gap with the GIP

What is the asthma gap? It’s the gap between recommended best practices for asthma care and the asthma care that patients actually receive. Communities that have not bridged this gap face poorer asthma outcomes.

What is the GIP? It refers to the Guidelines Implementation Panel (GIP) Report, which outlines six priority messages based on the Expert Panel Report 3–Guidelines for the Diagnosis and Management of Asthma (EPR-3) and key strategies to help clinicians and their patients improve asthma care and control. The National Asthma Education and Prevention Program (NAEPP), coordinated by the National Heart, Lung, and Blood Institute (NHLBI), directed the development of both reports.

Dr. Michael LeNoir helps patients and providers in minority communities get the tools, knowledge, and resources they need to control asthmaDr. Michael LeNoir helps patients and providers in minority communities get the tools, knowledge, and resources they need to control asthma.

“The GIP messages are good,” said Michael LeNoir, M.D., a practicing consulting allergist and pediatrician in the San Francisco Bay Area, CEO of the multimedia Ethnic Health America Network, and principal investigator for the National Medical Association’s Strategic Partnership with the NAEPP’s National Asthma Control Initiative (NACI). “They get at the essence of asthma care.” But Dr. LeNoir believes that the GIP messages alone are not the answer to addressing asthma disparities. Educating patients to better understand asthma, and ensuring that providers know why the GIP messages are important, is also essential.

Dr. LeNoir has dedicated his life’s work to improving asthma care and control among minority communities for whom there is a gap in care, and he believes that the GIP messages can and have had an impact where there are well-coordinated systems for asthma care already in place.

The challenge is that in many African-American and other minority communities such systems don’t exist.

“What always stuns me wherever I go is how little information physicians have that there even are guidelines, or how to use them: The GIP messages in isolation don’t have much impact outside the context of the guidelines.”

Many physicians do not understand that asthma is a chronic disease that requires ongoing monitoring of asthma control and follow-up visits. Dr. LeNoir believes a broader national program is needed to educate physicians, especially in high-risk areas, and to provide them with the necessary tools and resources for implementing the GIP messages. His ultimate aim? To ensure the highest standard for asthma care, especially in communities where asthma is poorly controlled and asthma disparities are greatest.

“There are communities across the country with the highest risk for asthma morbidity and mortality that have no idea about GIP and the guidelines. What have been the strategies to get these messages to them?” he asks.

Those strategies are being developed: LeNoir himself is spearheading one of them, the National Medical Association’s (NMA) Asthma and Allergy Rescue Project. Funded in part by the NACI, the project has developed an online physician training program and asthma toolkit to help physicians and their patients put the GIP messages into practice. In addition, the project has established and deputized a core group of NMA champions to educate other physicians in at-risk communities. The NMA has piloted the training in its regional meetings, annual convention, and in two cities: Detroit and Washington, DC.

The NMA project also focuses on delivering educational messages that meet the specific needs, literacy level, and cultural relevancies of patients. It promotes asthma education that includes the GIP messages directly to minority consumers through media they use as part of a health education campaign called Take Control of Your Asthma. “In our community we have a saying—‘If you knew better, you’d do better,’” LeNoir stated. “We don’t expect enough from our patients. We need patients to think differently about their disease. But first we need to give them the information and tools they need.”

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Last Updated October, 2011




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