UCF Doctors Join National Asthma Study to Improve Care for Black and Latino Patients

According to a nationwide study conducted with the help of two UCF physicians and recently published in the New England Journal of Medicine.

Doctors recently updated treatment guidelines for patients with moderate to severe asthma who start coughing and have trouble breathing during an asthma attack. As well as using a nebulizer or inhaler, the new guidelines suggest that patients also take an inhaled corticosteroid – which reduces lung inflammation and excessive mucus production – two debilitating symptoms of asthma.

Black and Latino patients face a disproportionate burden of asthma-related complications — including increased emergency room visits, hospitalizations, and about double the death rate from the disease, according to UCF Medicine Professor Magdalena Pasarica, who was part of the study. So a team of researchers from Harvard’s Brigham and Women’s Hospital proposed a study to see how the new guidelines were impacting the communities most affected by asthma.

The researchers found that the new guidelines resulted in a 15% decrease in severe asthma events, better asthma control, improved perceived quality of life and fewer days patients were absent from work, from school or could not enjoy the events of daily life. Corticosteroid use also reduced patients’ use of the nebulizer or rapid-acting inhaler, which is important because overuse of these treatments has been associated with a higher incidence of asthma death.

The UCF expert is involved

Brigham and Women’s Hospital investigators contacted the American Academy of Family Physicians (AAFP) for assistance in collecting a diverse national sample of patients. Pasarica, a member of the group well known for her expertise in clinical research, was approached to participate as the site’s principal investigator.

Magdalena Pasarica, professor of medicine at UCF, with students from the Knights Clinic.

“I’m passionate about helping the underserved and clinical research,” says Pasarica, who is also the medical school’s assistant dean for medical education. “I was excited to help with the grant proposal and the potential clinical study.”

Funding for the study came from the Patient-Centered Outcomes Research Institute (POCORI), an independent, nonprofit organization committed to increasing research that directly impacts the lives of patients. As part of this project, researchers worked with asthma patients, their caregivers and health care providers.

“We had the voices of patients, their caregivers, nurses, doctors,” says Pasarica.

A total of 19 centers in the United States and Puerto Rico worked together to include 1,200 black and Latino asthma patients. The study included students treated at UCF Student Health Services and uninsured Orlando residents receiving care at Grace Medical Home, which is also the site of the College of Medicine’s free KNIGHTS clinic.

Pasarica, a family medicine specialist, led the UCF portion of the study in conjunction with James Schaus, medical director of Student Health Services.

How the study worked

The study ran from 2017 to 2021. Black and Latinx patients from Pasarica and Schaus received instructions on corticosteroid use, free steroid prescriptions, follow-up care for their asthma, and surveys of their symptoms.

“It’s very exciting to have the opportunity to show a new approach to asthma for those who are disproportionately suffering and underserved,” says Schaus. “This is a very useful and important discovery for our patients.”

Student Health Services brought a unique subset of patients for the study. Schaus explained that people often start showing signs of asthma in their late teens and symptoms can get worse during their college years. He says the “benefit was enormous” when his patients used the inhaled corticosteroid during an asthma attack. While steroids can impact the whole body, he says inhaled steroids have minimal systemic effects while significantly alleviating respiratory issues.

James Schaus, Medical Director of Student Health Services

Doctors say the next step will be to make corticosteroids more readily available to underserved communities. The cheapest steroid inhaler costs $200 a month without insurance, Schaus says. With insurance, the patient co-pay is approximately $40 per inhaler. While some participants only needed one steroid inhaler per year, patients with more severe asthma needed a new inhaler every month. Schaus says he hopes the latest research will show policymakers the need to rethink asthma treatment, pointing out that it’s more cost-effective for Medicaid or Medicare to pay $200 a month for a steroid inhaler compared to costs of asthma-related emergency room visits and hospitalizations.

“We have shown the effectiveness of this treatment for those most at risk,” he says. “But many of these patients are underserved. They don’t have an extra $200 a month for inhalers, so they can’t follow the recommendations we give them as doctors. I hope this study will help fill that need.

Comments are closed.