Improving Asthma-Related Outcomes Among Children Participating in the Head-Off Environmental Asthma in Louisiana (HEAL), Phase II Study.

PURPOSE: Pediatric asthma disproportionately affects low-income and minority children. The HEAL (Head-Off Environmental Asthma in Louisiana), Phase II Project was a collaborative effort with a primary focus to improve pediatric asthma management in New Orleans, Louisiana. The purpose of this article is to report clinical outcomes captured at baseline and 12-month follow-up. METHOD: HEAL (Head-off Environmental Asthma in Louisiana), Phase II was a pre-post intervention study that enrolled children ages 2 to 18 years of age with a diagnosis of asthma to receive asthma education within the clinic setting. Enrollees received an asthma education intervention, an environmental evaluation, and a 12-month follow-up session. Endpoints included symptom days, level of asthma control, asthma exacerbations, emergency room visits, hospitalizations, and missed school days. RESULTS: The majority of participants were aged 5 years and older, male, Black, and persistent asthmatics. Emergency room visits decreased from 41% to 20% ( p < .001). Improvements in coughing (83% to 62%, p < .001), wheezing (50% to 26%, p < .001), and chest tightness (29% to 18%, p < .001) were also seen. CONCLUSION: The novel intervention was associated with improved asthma outcomes among pediatric patients receiving care at the clinical sites in the Greater New Orleans area.

Prescribing Patterns of Metformin in High-risk Patients with Prediabetes.

AIMS: The primary objective of this study is to examine the rates of metformin prescribing in patients with prediabetes who are either less than 60 years of age, have a BMI greater than 35 kg/m2, or women with a history of gestational diabetes mellitus (GDM). Secondary objectives include: 1) examination of the time from diagnosis of prediabetes to the initiation of metformin and 2) if metformin initiation status and length of time correlates to the patient having any other additional diabetes mellitus (DM) risk factors. METHODS: This was a single center, retrospective cohort study. This study included all patients with prediabetes, defined as having hemoglobin A1c (HbA1c) of 39 through 46 mmol/mol (5.7-6.4 percent), who were patients at the Interim LSU Hospital and Clinics from January 2012-September 2013. RESULTS: There were a total of 13 patients out of 160 patients in the study population who were prescribed metformin for an overall metformin initiation rate of 8.1 percent. The metformin initiation rate for the three individual groups; history of GDM, aged less than 60 years, and BMI greater than 35 kg/m2 were 0 percent, 9.0 percent, and 17.5 percent respectively. CONCLUSION: Metformin initiation rates in patients with prediabetes are not in accordance with current recommendations, and provider education is necessary to increase rates to delay or prevent the progression of prediabetes to type 2 Diabetes Mellitus.

Lessons from a cross-institutional online professional development pilot.

PURPOSE: To reflect on a collaborative approach used by a group of faculty and administrators from historically Black colleges and universities (HBCU) and predominantly Black institution (PBI) pharmacy programs to provide high quality, multiple institution, faculty development programming in online environments. DESCRIPTION: A pilot for a shared online professional development initiative between pharmacy programs at five HBCUs and one PBI was implemented as a two-hour combined video conference and webinar, with structured networking, instructional programming, and breakout group sessions. Learning outcomes focused on increasing knowledge and awareness of mindsets in faculty and students with additional project goals of beta-testing interactive web conference formats, developing cross-institutional networking, and identifying avenues for sharing resources and expertise. ANALYSIS/INTERPRETATION: Kolb's Cycle of Experiential Learning (Concrete Experience, Reflective Observation, Abstract Conceptualization, and Active Experimentation) was used to guide reflection on the joint workshop. The instructional design, delivery, and learning experiences of the program itself were analyzed using Garrison's Community of Inquiry Framework. CONCLUSIONS: Action research approaches can be applied to facilitate the continuous quality improvement cycle in multi-institution initiatives, such as joint faculty development programming. IMPLICATIONS: Lessons related to cross-institutional collaboration, communities of practice development, networking, and communication can be used for future joint faculty development sessions and other shared initiatives for institutions serving minoritized students as well as other multiple institution consortiums.

The HEAL, Phase II Project: enhancing features of an electronic medical record system to improve adherence to asthma guidelines.

This article describes the implementation of an enhanced electronic medical record (EMR) system in three community health care centers in the Greater New Orleans area of Louisiana. This report may aid efforts directed at the implementation of enriched tools, such as decision support, in an EMR with the goal of improving pediatric asthma outcomes.