Towards an Integrated Clinical Pathway for the Treatment of Pediatric Asthma

Christopher Huson, LAc

According to the Centers for Disease Control and Prevention, “Over 9 million U.S. children under 18 years of age (13%) have ever been diagnosed with asthma, and 6.5 million (9%) still have asthma.”(1)  Most children with asthma in the United States are “managed” by conventional medical care. However, a treatment plan integrating conventional medicine (CM) and Traditional Chinese Medicine (TCM) may prove to be more economical than stand-alone CM care. By using the outcomes measurements designed for the assessment of conventional medicine we can compare the long- and short-term effects of including TCM in the treatment model.

The western medical approach to pediatric asthma is well-established. Children’s asthma is “managed” by the use of bronchodilators to treat acute attacks, and corticosteroids for “control” of symptoms during chronic (remission) periods. Allergic triggers in diet and environment are identified and avoided. TCM’s approach to pediatric asthma is also well-established: patients are assessed through differential diagnosis and treated with a combination of acupuncture, herbal medicine, medical massage, dietary therapy, and exercise.

It appears there may be enough similarity between the two (TCM/CM) systems’ differential diagnosis and treatment of pediatric asthma to allow for the development of an integrative clinical treatment pathway featuring both TCM and CM. Comparative efficacies can be determined by existing standards of outcomes measurement. These include: peak expiratory flow metering, pulse oximetry, spirometry, use of asthma-related health care services, use of anti-inflammatory medications, changes in functional status, quality of life assessment, measurement of total or asthma-related school days lost.

The American healthcare marketplace measures medical efficiency through cost-effectiveness. Integrative approaches for the treatment of knotty public health dilemmas are not only being defined, they’re being funded! If, through the development of an integrative clinical pathway for the treatment of pediatric asthma, we can prove that it is beneficial to employ both TCM and CM together, this may prove to be beneficial both to our children and our profession.

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(1) p4. Summary Health Statistics for U.S. Children: National Health Interview Survey, 2005, U.S.Department of Health and Human Services, Hyattsville Maryland 2006