Clinical Pediatrics and Pediatric Surgery

Asthma is the leading chronic disease in children with prevalence of pediatric asthma close to 10% in United States as per recent CDC figures. Asthma has been increasing since the early 1980s in all age, sex and racial groups. In US, one in ten individual dies of asthma daily. Many of these deaths are avoidable with proper treatment and care. Asthma disproportionately affects low-income, minority and inner city populations with higher morbidity and mortality rates. Much of the risk of asthma in minority children can be attributed to local irritants, including secondhand cigarette smoke, mold, cockroaches, dust mites, rats, mice, pets and air pollution. Increased recognition of the occurrence of sudden, unexpected deaths is a compelling reason to search for the mechanisms of death. This is particularly true since it has been apparent that even patients with mild asthma appear to be at risk for such an outcome. Unfortunately studies of mechanisms in these patients have been difficult due to logistic reasons and lack of autopsy. There has been very limited literature reflecting on pediatric asthma mortality and so far there has been only eight reports of programs set up to investigate individual asthma deaths (5 in UK and one each in New Zealand, Australia and US). Although new and better treatments for asthma become available each year, the latest information on these new treatments often is not communicated effectively to patients. These communication problems lead to ineffective management of the disease. The Physician Asthma Care Education (PACE) program was created to enhance treatment of asthma and the physician-patient partnership. The PACE program is a two-part interactive, multi-media educational seminar to improve physician awareness, ability, and use of communication and therapeutic techniques for reducing the effects of asthma on children and their families. The PACE curriculum provides education for clinicians on how to employ the best current therapies for asthma. It also provides valuable information on how to communicate more effectively with patients and support patients’ management efforts, helping them to better utilize the clinicians’ recommendations.