- Volume 4 | Winter 2010
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NACI Partner Profile
Making the Land of Enchantment a More Magical Place for People in New Mexico Who Have Asthma
New Mexico is home to an average of 16 people per square mile, making it one of the nation’s least populous states. But that doesn’t mean the Land of Enchantment carries any less of an asthma burden than other states. A high unemployment rate, as well as a large number of at-risk communities, creates even greater challenges for asthma experts such as Romelia Rodriguez Walters, AE-C, with Asthma Allies, in Albuquerque, the state’s largest city.
“We have 12 specialists [allergists and immunologists devoted to asthma] in our state, nine of whom are here in Albuquerque, and their waiting lists are just tremendous. We do have pulmonologists; however, a very small number actually do asthma,” said Ms. Rodriguez Walters.
And so Rodriguez Walters and her team began looking at how to better address asthma in their state, and came across the idea of home visits. In late 2009, Asthma Allies had a chance to test that idea, thanks to demonstration-project funding through the National Asthma Control Initiative.
Enter the Home Visit Asthma Management Program (HVAMP) demonstration project. HVAMP sends respiratory therapists into the homes of people ages 12 and older who have recently been diagnosed with asthma. These professionals help educate patients about how to manage the disease, including ways to decrease their exposure to asthma triggers both in and outside of the home—and much more.
Romelia Rodriguez Walters, Asthma Allies (Albuquerque, NM), presenting new HVAMP tools at NAEPP-NACI 2010 Meeting.
“One particular case that sticks with me is a woman with three cats who said that she’s only ‘just a little’ allergic to cats, but that she has daily asthma symptoms,” said Rodriguez Walters. “She wasn’t going to get rid of her pets—I wouldn’t either—but we showed her how to keep them out of her bedroom, take them to the groomer, and clean on a regular basis.”
Each of HVAMP’s 26 current participants is visited three times by a respiratory therapist—accompanied by a student in the health care field—who takes the following steps (which are consistent with the six priority actions (a.k.a. GIP messages):
- Uses a spirometer to measure how well the patient’s lungs are working
- Administers a knowledge survey and an Asthma Control Test™
- Makes sure that the patient has an asthma action plan
- Teaches the patient about environmental triggers in the home
- Encourages the patient to use prescribed inhaled corticosteroids
- Recommends that the patient sees a specialist after the third visit
After the last visit, Asthma Allies follows up with calls at one month, three months, and six months.
“We want to see if they’re still incorporating the changes and using their asthma action plan,” said Rodriguez Walters. “We walk through the skills check: ‘How do you use your inhaler? How do you clean your spacer? Let’s do a scenario with your asthma action plan, and tell me what you would do.’”
It hasn’t necessarily been easy. Ms. Rodriguez Walters reports that it’s often a struggle to get patients to fill their inhaled corticosteroid prescriptions.
“They either don’t fill it because they don’t have money; they don’t have insurance; or they don’t think they need it,” said Ms. Rodriguez Walters. “There are different reasons why they don’t, but we really have our educators stress to them how important that [taking their medications] is to their overall wellbeing. And to help them see the differences, we give them a journal so that they can track how they’re feeling throughout the whole process.”
Ms. Rodriguez Walters says another initial challenge was finding collaborating partners, and getting primary care physicians to refer their patients to the program. Nonetheless, Asthma Allies is making headway and actually has a waiting list.
“We’ve had tons of requests from parents of children younger than 12, and we’re looking at that to see if maybe we can incorporate them into a third year, because we still have a huge waiting list,” said Ms. Rodriguez Walters.
The group hopes to enroll some 50 patients in the second year of its program, in 2011.