Sarov/Los Alamos Partners Hold First Asthma Day

To help disseminate information about asthma care to patients and physicians in Sarov, Russia, the Sarov/Los Alamos partners held Asthma Days June 18-19. Approximately 240 people—including adult and pediatric asthma patients and some 40 physicians—attended the two-day event that included lectures on the topics of diagnostics and treatment of asthma, broncho-obstructive syndrome in children, and chronic obstructive lung disease, and featured talks from three Moscow physicians. The events were part of several planned activities that stemmed from an asthma pilot project developed by the Sarov/Los Alamos partners who identified the condition as a growing medical problem and public health need in Sarov during their assessment of the region.

Dr. Andrey Belevsky gives a lecture during events held on Asthma Day in Sarov, Russia. (Photo courtesy of Phil Hertzman)

"We developed the pilot project in an attempt to improve the care and outcomes of asthmatic patients by implementing a comprehensive intervention program with emphasis on physician and patient education, patient self-management, medical care based upon published national and international guidelines, and prospective outcome analysis," says Phillip A. Hertzman, medical director of the Los Alamos Medical Center.

The three physicians from Moscow who addressed attendees were Andrey Belevesky, head of the Pulmonology Department at the Russian State Medical University (RSMU), Nadezhda Knyazheskikh, associate professor also in the Pulmonology Department at RSMU, and Vera Revyakina, chief allergist and head of the Inpatient Allergy Department at the Russian Academy of Medical Sciences'Scientific Center of Children Health. Other participants at the event included Jeri Hertzman, US project coordinator for the Sarov/Los Alamos partnership, and Larisa Kozyreva, head of the Therapeutic Department at Central Medical Unit #50 in Sarov.

During their visit to Sarov, the Moscow physicians also worked on a number of other aspects of the asthma project with the Sarov team, which includes Tamara Gorbenko, immunologist and allergist at Central Medical Unit #50; Phil Hertzman; Larisa Kozyreva, Irina Parfenova, an English teacher at Sarov School #2; and Natalyiya Trifonova, pediatrician at Central Medical Unit #50. The group collaborated on a scientific manuscript, which will be submitted to a peer-reviewed medical journal; examined and discussed the care of patients with "difficult asthma;" and finalized plans for implementing the Global Youth Tobacco Survey (GYTS) in Sarov schools. In addition, the physicians received further training in the use of the spirometer—a device that assesses lung functions—and its advanced software.

Guidelines Introduced and Future Plans
After completing a six-month asthma pilot program in April 2001 that initially involved the analysis of 115 patients, the partners adapted guidelines based on the results of the study. According to Hertzman, the main goals in the current phase of the project are expansion, dissemination, integration, and replication. Recently, the project was expanded to include 195 patients.

In addition to presenting papers and posters describing their project at the World Asthma Meeting July 2001 and at the American Thoracic Society Meeting in May 2002, the Sarov/Los Alamos partners will give a talk at the European Respiratory Meeting in September 2002. Future plans include sharing the results of the GYTS survey, initiating training methods to help patients quit smoking, and collaborating with the Sarov WWC psychologists to teach asthma patients the proper use of rescue inhalers to prevent unnecessary use. They will also integrate projects involving diabetes, hypertension, women's wellness, and adolescent risk reduction with other partnership activities conducted by the asthma team.

Larisa Kozyreva (far left) presents a case on a patient with "difficult asthma" to Phil Hertzman for advice and discussion. With them is Natalyiya Trifonova. (Photo courtesy of Phil Hertzman)

"We have replicated the model that we have developed for care of patients with asthma in Sarov to develop pilot projects for patients with diabetes and hypertension," Hertzman said, adding "I am proud that through the work of a team of motivated physicians in Sarov, we have begun to make significant progress towards improving the care and outcomes of patients with asthma, advancing the culture of healthcare, modifying physician behavior, and effecting public policy in the community."

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