Pediatric Asthma Disease Management Program (PADM)

What is PADM?

The Pediatric Asthma Disease Management Program (PADM) at QueensCare Family Clinics offers a state-of-the-art, integrated model of pediatric asthma prevention and treatment. Its purpose is to measurably improve the diagnosis, treatment and control of asthma in QFC’s pediatric patients. PADM is based on the Bureau of Primary Health Care’s Chronic Care Disease Management Model and incorporates national guidelines and “best practices” into its operational modalities.

PADM is led by QFC staff pediatrician Robert Vinetz, MD as its Program and Medical Director. He is supported by Emma Wolfe, MPH, CHES as the Project Director.

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Services provided by PADM

The centerpiece of the program is the Community Health Worker (CHW) or Promotora de Salud model. CHWs, who have completed training as Promotoras de Salud (Health Promoter) are recruited from the community. They are bilingual, bicultural and provide culturally sensitive health information. CHWs, under the direction and supervision of pediatricians, work with clinic staff to provide a variety of services to patients, including asthma education, medication and device instruction, case management support and linkages to resources in the community. CHWs also conduct home visits to help the family identify and work on goals to reduce environmental triggers that exacerbate their child's asthma.

Studies show that when families are educated, empowered and become proactively involved in their child's asthma control, their children are less likely to go to the emergency room, have less sleepless nights because of coughing, and miss less school days and play activities due to asthma symptoms.

PADM is also designing asthma-specific forms to be used in QFC’s electronic health record, providing support to pediatricians and clinic staff and collaborating with community organizations, such as Children’s Hospital Los Angeles, Los Angeles Unified School District, the Breathmobile program and asthma and allergy specialists.

What is asthma?

Asthma is a chronic disease of the airways (bronchi) that carry air to the lungs. The airways are extra sensitive to irritants and allergens called asthma “triggers”. The triggers cause the airways to become narrow; airway linings become irritated, swollen and inflamed. In most patients with asthma, the airways are always irritated and inflamed, even when the patient has no asthma symptoms. Symptoms of asthma, such as cough or chest congestion or tightness, difficulty breathing or wheezing worsen when a patient is exposed to substances such as dust and dust mites, cockroaches, mold, cigarette smoke and animal dander from cats and dogs (American Academy of Pediatrics). Although there is no cure for asthma, it can be controlled through medical treatment and management of environmental triggers.

Source: National Heart Lung and Blood Institute

In Los Angeles County, it is estimated that 14% of school-age children (in addition to children as young as a few months old) have asthma. According to new research from the UCLA Center for Health Policy Research, in 2005, California’s children missed 1.9 million days of school and the state's adult workers missed 2 million days of work due to asthma. Children living below the 200% federal poverty level are nearly twice as likely to visit the emergency room as children living above that poverty level. PADM is well placed in urban Los Angeles to offer a multi-pronged approach to asthma treatment and prevention.

Where is PADM today?

PADM is currently offered in QueensCare Family Clinics Hollywood, Bresee, Echo Park and East Los Angeles clinics.

Future Plans

PADM will start providing services in QFC’s Eagle Rock clinic in Summer 2010.

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