Controlling Asthma in St. Louis CASL

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Controlling Asthmain St. Louis (CASL)

• Mario Castro MD, MPH
• St. Louis Regional Asthma Consortium

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CASL
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Controlling Asthma in St. Louis (CASL)
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CASL Implementation Plans2004 - 2008

• Promoting Best Practices Committee
• Healthcare Provider Education (CAP)
• Improve PCP clinic and support staff delivery of
  asthma care using CQI model and standardized
  asthma educational material (11 public health
  clinics, 44 PCPs)
• Based upon NAEPP guidelines severity assessment
  and appropriate treatment
• Community Asthma Program training now has PACE
  communication strategies incorporated
• Improve link to pharmacy, schools, ED/hospital

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Community AsthmaProgram Improves Appropriate
Prescribing in Moderate to Severe Asthma

• Prospective, observational study
• One year time frame
• 723 children and adults with asthma
• 2 primary care urban clinics
• CAP trained clinical staff evaluated
• pediatricians, nurse practitioners, family
  practice physicians, internists

Moonie S, Strunk R, Crocker S, Schechtman K,
Castro M. Submitted.
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Agreement Between Patient Self-Reported Asthma
Symptoms and Primary Care Provider (PCP)
Classified Asthma Severity
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CASL Implementation Plans2004 - 2008

• Promoting Best Practices Committee
• Community Pharmacist
• Asthma Friendly pharmacies (AFP) that provide
  brief or intense asthma intervention (Public
  health clinics, Walgreens/Schnucks)
• Provision of asthma medication assessment, device
  technique
• Link to Missouri Medicaid Disease State
  Management
• Provide link to PCP using fax communication
• Marketing plan of AFP

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CASL Implementation Plans2004 - 2008

• Gathering of Asthma Info Committee
• Evaluation of CASL
• Assist in CAP evaluation by analyzing 3rd party
  payer information on CAP enrollees
• Development of survey of Consortiums
  effectiveness
• Evaluation of Medicaid Pharmacy data to track
  outcomes

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CASL Implementation Plans2004 - 2008

• Barriers and Resources Committee
• School Nurse/Student Education
• Implemented RGS District (12 schools) roll-out
  in Jennings SD (8 schools), City (75 schools) and
  Archdiocesan schools (25 schools)
• Tracking asthma-related school absences/knowledge/
  QOL
• Piloting CD educational programs (Impact, Quest)
  - 3 so far
• Provision of Medical Directorship using CAP model
• Utilization of existing Parent Liaisons in City
  schools
• Integration of asthma education into existing
  curriculum (science, math, reading)

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Creating the Linkages in CASL Community

• Linkage among the components
• Capacity building - utilizing existing resources
  in a fragmented community
• Community building through Consortium
• Examples
• CAP PCP refers pt. to AFP Pharmacy
• AFP Pharmacist identifies medication
  contraindication then contacts PCP
• School nurse/Medical Director referral to PCP

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Controlling Asthma in St. Louis Team

• CAP/3rd Payors
• Mario Castro (PI)
• Vanessa Curtis
• School
• David Sterling
• Colleen Richmond
• Santosh Krishna
• Consortium
• Keith Willis (ED)
• Kristin Wilson (PD)
• Heather Kelly
• Lucy Reinhart

• Pharmacy
• Theresa Prosser
• Tricia Berry
• ED/Hosp
• Mitch Grayson
• Larry Lewis
• Gabe Highstein
• Evaluation/Data
• Rick Kurz
• Marcia Hendrix
• Sheniz Moonie