Study To Determine Effectiveness Of Multidisciplinary Treatment At National Jewish

Chronic, out-of-control respiratory or immune system illnesses impact every aspect of a child’s life. Children who have respiratory or immunological illnesses, such as allergies, atopic dermatitis or vocal cord dysfunction, experience hospital emergency room visits, absences from school and a limitation on activities. The families of these children also bear a great burden, both economically and psychologically. Previous studies have focused on the outcome of children with chronic asthma.

The new study conducted by Mary Klinnert, Ph.D., Donna Bratton, M.D., and Dan Atkins, M.D., will involve 100 pediatric patients who have respiratory and immunological illnesses other than asthma. These illnesses include food allergies, atopic dermatitis and vocal cord dysfunction.

Patients selected for the Pediatric Outcomes Study will participate in either the Pediatric Day Treatment Program or the Pediatric Outpatient Program at National Jewish. Patients will be monitored for two years following their treatment to determine the effectiveness of involvement in either of these multidisciplinary programs.

“We want to determine how we are helpful to kids that come through National Jewish with either asthma or the other illnesses we treat,” says Dr. Klinnert, a psychologist in the Department of Pediatrics. “We want to see how these treatment programs result in better physical functioning, better health care utilization and improved quality of life.”

Improved quality of life is measured by criteria such as fewer limitations on activities, less anxiety and greater emotional stability.

For the Pediatrics Outcomes Study, Dr. Klinnert notes, “Children with atopic dermatitis are of particular interest to us.” Atopic dermatitis includes environmentally-linked skin disorders such as eczema. “Little information is available regarding the psychosocial characteristics of the families of these children, or of the effectiveness of multidisciplinary interventions in bringing the illness under control,” Dr. Klinnert adds.

The new Pediatric Outcomes Study is a successor to a Pediatric Asthma Outcomes Study initiated in 1998 that focuses on asthma patients. The preliminary indications for the Asthma Outcomes Study have been extremely positive. “We’ve seen a great decrease in the frequency and severity of symptoms such as wheezing, coughing and shortness of breath. Health care spending also decreased dramatically and quality of life improved,” Dr. Klinnert notes.

Before participating in the Pediatric Asthma Outcomes Study, a typical child required frequent hospital visits and medication. One year after the program, patients were significantly better, and the average yearly medical costs per child dropped 89 percent, from $16,000 to $1,800. These savings appear to be sustained through the second year of the study. Preliminary findings indicate that the asthmatic children used 53 percent less steroid medication in the two years following their participation in the study. “This is especially important,” Dr. Klinnert says, “since kids who use steroids can suffer side effects including suppressed growth, weight gain, weakened bones, high blood pressure and cataracts.”

The new Pediatric Outcomes Study builds upon and extends the Asthma Outcomes Study. Both studies are funded by the Scholl Foundation.

National Jewish conducts additional, unrelated outcomes studies on its patients.

The Number 1 Respiratory Hospital in the U.S. for Two Consecutive Years, U.S. News & World Report, 1998-2000.