Respiratory care student Kelli Hand from The University of Texas Health Science Center at San Antonio was recognized this week along with 67 other students from 57 different academic institutions from all over the country during Texas Undergraduate Research Day at the Capitol in Austin. Ms. Hand, who is still earning her bachelor’s degree in science, was invited to the event due to her promising research on asthma education and diagnosis.
The research conducted by Hand in collaboration with follow student Amer Marquette is entitled “An Observational Study of Fractional Exhaled Nitric Oxide Levels in Elementary School Children Who Have Been Diagnosed with Asthma” and the results were presented during the 2014 conference of the American Association for Respiratory Care in Las Vegas.
The students conducted the 2+2 Asthma Education Program from the UT Department of Respiratory Care with children in local elementary schools who suffer from asthma. Hand sought to better understand the process of asthma diagnosis in young children, as the program received funding from a McCaffree Humanitarian Award granted by the CHEST Foundation.
“We were measuring the Fractional exhaled Nitric Oxide or FeNO levels by having the children blow into a disposable mouthpiece attached to the Aerocrine NiOx device,” explained Hand. “When they blew into the device, the kids could see on an interfacing laptop the effect of their breath on a girl, who resembles the main character from the `Dora the Explorer’ TV show, in a hot air balloon. When they inhaled, a sun rose to the top of the screen, and when they blew out, they could see the hot air balloon move across the screen.”
For the study, children were entertained with colorful graphics while the FeNO levels, which indicate inflammation in the lungs, were measured. The examination reveals whether the disease is controlled or not, as well as the body’s response to inhaled corticosteroids, which are the most typical medication to manage asthma. Used daily, the drugs can reduce the risk of airway inflammation and exacerbations, but the study revealed that 37% of the children had intermediately controlled or uncontrolled asthma.
“Unfortunately, these numbers were on par with what we found in current literature, when we reviewed published studies. We know this places these students at increased risk for asthmatic attacks, hospitalizations and even death,” stated the student. “In theory, all the children we saw should have been taking the controller medications, an inhaled corticosteroid, to best manage their asthma.”
In addition to the examination, the 2+2 Asthma Education Program also included a discussion with parents and a pulmonologist in order to reinforce the importance of treating children with controller medication. “We learned that sometimes families don’t have the money to buy the needed medicine. We also found a lack of education about asthma as a barrier to proper management of the disease. Many do not fully grasp the gravity of the situation,” she added.
The students believe that the results of the study and the educational program may help improve the treatment of children with a managed disease. Furthermore, they have the support of faculty advisors Richard Wettstein and Donna Gardner, who are willing to use the research to encourage physicians, such as pediatric allergists and pulmonologists, to use the FeNO measurement device regularly.
“If physicians could test FeNO levels at each visit, they could monitor the levels,” explained Hand. “This would allow them to reinforce to each patient the importance of the controller medication regimen. This could be another tool to help in the care of each patient with asthma.”
“The importance of this research is to stress the use of the device to help reinforce that asthma patients use their controller medications, which are the inhaled corticosteroid,” added Gardner. “Those with high levels demonstrate inflammation that is caused by eosinophils which are disease-fighting white blood cells, and these patients will most likely respond to inhaled corticosteroids to best manage asthma.”