By Bobby Hundley, UNC Health Foundation
In the midst of a public health crisis centered around a virus that attacks the lungs, asthma continues to be of great concern to Stephen Tilley, MD, and his team. A life-long Tar Heel who has dedicated his career to this widely prevalent pulmonary condition, Tilley was motivated to pursue asthma research and clinical care when his son was diagnosed with asthma at the age of 3.
Asthma is the most common chronic disease among children in the U.S. and among the most common diseases of adults. Dr. Tilley has been conducting basic science research on asthma pathogenesis for more than 20 years, with an eye towards improving therapies.
But in recent years, Tilley has worked to fill a growing need for adult asthma care and clinical research by establishing the UNC Adult Asthma Program. This program is designed to provide comprehensive clinical care to adults suffering asthma, to expand clinical asthma research at UNC, and to continue fundamental lab-based investigation looking for causes and a cure.
“Despite being a major medical center, UNC has never had an adult asthma program,” Tilley said. “Our major goal for this program is to improve life for our patients, to keep them out of the emergency room, to keep them out of the hospital and to reduce their symptom burden. We also aim to provide access to new asthma therapies though access to clinic trials of new drugs.”
Improving Access To Treatment – “Time and Education”
Patients without access to care or reduced health literacy are particularly vulnerable to hospitalizations due to asthma. In many cases, patients are suffering simply because they are using their inhalers incorrectly. That’s a problem that Kristie McNeill is committed to fixing.
McNeill is a registered respiratory therapist based in Pittsboro who has spent more than 30 years working to educate patients on how to better manage their asthma symptoms. For McNeill, it’s a deeply personal pursuit.
“The reason that I went into respiratory therapy was probably because of my father,” McNeill said. Dealing with COPD, he lived another 20 years after his diagnosis due in large part to McNeill’s knowledge and assistance. “Helping him manage his lung disease was the biggest thing, it was family. I think that’s what has continued to motivate me to help others.”
Her passion extends to what she sees as the two most important barriers to care for pulmonary patients – time and education.
“I think patients need some kind of educational support and coordination specifically aimed at helping them learn what they should be doing and how to do it,” McNeill said.
Mary Clark, practice manager at the clinic where Tilley and McNeill care for asthma patients, is enthusiastic about the future of the Adult Asthma Program.
“As a practice manager, nurse, COVID survivor and asthma patient, I’m very excited about the asthma program,” Clark said.
Opportunity For Growth Through Philanthropy
“When grant funding runs out, we are limited in the amount of research that we can do,” Tilley said. His research technician of the last 10 years is funded by NIH grants which run out early next year. For the time being, Tilley is forced to loan her to other programs and rely on contract work for other key roles. In the absence of grant funding, which is notoriously slow to develop, private contributions are critical. Recent gifts from visiting researchers have allowed the basic science research in asthma to continue despite lapses in NIH funding, but there is still an ongoing need.
“In addition to supporting our asthma research efforts, increased funding would also allow us to improve clinical care by hiring a dedicated asthma nurse and an asthma pharmacist,” Tilley said.
With greater funding support for the clinic, McNeill sees an incredible opportunity to improve outcomes for those struggling with asthma. “You need someone specifically advocating for patients, especially older patients who may not have access or understanding of technology.”
For now, Tilley and his team are working with other campus groups to advocate for innovative ways to help patients. For example, they are working with the UNC Center for Health Innovation to study the potential of digital inhalers to improve asthma care. In these inhalers, information about technique and frequency of use is sent to the patient’s smart-phone. This information can be used by the patient, and if the patient chooses, be sent to a cloud-based server and downloaded to a dashboard that can be monitored by providers.
Ultimately, however, it still comes down to access to resources and education.
“Despite really great drugs for this disease, a large percentage of people are living with uncontrolled asthma because they either can’t get them or they aren’t using them properly.”
With that in mind, an increase in funding will not only benefit staff and research capabilities, but will lead to improved resources and education for the many asthmatic patients Dr. Tilley and his colleagues serve.