Improving Asthma Care: Adapt-NC

Improving Asthma Care: Adapt-NC

ADAPT-NC is a research study implementing a shared decision making toolkit in primary care practices to improve asthma outcomes across North Carolina.

ADAPT-NC stands for Asthma Dissemination Around Patient-centered Treatments in North Carolina. It is a state-wide dissemination project funded by the Patient-Centered Outcomes Research Institute (PCORI). In the ADAPT-NC project, the research team has leveraged partnerships between the statewide Medicaid network and the statewide consortium of research networks to identify best practices for dissemination of an evidence-based shared decision making (SDM) toolkit for asthma management. The asthma toolkit development was funding by the Agency for Healthcare Research and Quality (AHRQ) and tested across a regional network of pediatric, family medicine, and internal medicine ambulatory practices in Mecklenburg County, North Carolina. The initial results have showed marked improvement in patient outcomes (improved medication adherence and decreased asthma exacerbations) with increased patient involvement in the creation of the care plan. For more information and results from the asthma shared decision making toolkit development (through the Asthma Comparative Effectiveness study):
Tapp H, McWilliams A, Ludden T, Kuhn L, Taylor Y, Alkhazraji T, Halladay J, Derkowski D, Mohanan S, and Dulin M. Comparing traditional and participatory dissemination of a shared decision making intervention (ADAPT-NC). Implementation Science 2014; 9(1): 158. Mowrer L, Tapp H, Ludden T, Kuhn, L E Reeves, K, Courtlandt, Cheryl, Hege, Tami Taylor, Y McWilliams, A, Dulin, M. Patients’ and Providers’ Perceptions of Asthma and Asthma Care: 2015 A Qualitative Study. J of Asthma. 2015 May 15:1-8. During ADAPT-NC, key principles of community based participatory research were used in engaging providers and patients to develop a facilitator-led participatory approach to dissemination. This This study will test a novel method for dissemination on a larger scale by randomizing 30 practices to 1 of 3 arms:
1. Facilitator-Led Participatory Approach to Dissemination (FLOW)
2. Traditional Dissemination (one didactic session with educational material)
3. Control with no dissemination

The objective of this trial was to examine whether a facilitator-led (FLOW) approach to dissemination would result in a higher level of SDM than a traditional lunch-and-learn approach. Outcomes measured include 1) reduction in asthma exacerbations, 2) Beta agonist over use, 3) controller medication use, 4) reported practice level use of the SDM toolkit, and 5) patients’ perceptions of involvement in their asthma care decisions. The FLOW approach to dissemination may be a more effective way to incorporate SDM into practices by helping providers overcome traditional implementation barriers and has the potential for greater sustainability by considering unique practice characteristics.


Welcome! May all your proposals find funding and your studies be patient-centered 😊

The WVPBRN has joined Facebook!

Follow our page for the latest project updates, events happening at our sites around the state, and to learn more about the issues faced by this beautiful state!


We are celebrating our Clinical Trials teammates and #ClinicalTrialsDay! Have you ever wondered what type of research is considered a clinical trial? As Dr. Patel describes, "a clinical trial is a defined way to evaluate the effects of a new medication or combination of medications that haven’t been approved yet for a specific use."

We are so grateful for every patient participating in clinical research - the resulting improvements in medical care are all thanks to YOU!

Read more about clinical trials in the link below:

From new and innovative therapies not yet available to the public through Phase I clinical trials to promising immunotherapy treatments that activate your own immune system to attack your cancer cells, we're proud to celebrate #ClinicalTrialsDay and our work to advance the treatment of cancer. Curious about clinical trials? Here are 5 things to know:


Takes My Breath Away

Is yours up to date? Do you know what to do if your loved one has an attack?


Every March 5, we raise asthma awareness in honor of Lexie's birthday. Here is one of my favorite pictures from the Mecklenburg County Asthma Coalition - MCAC Asthma Walk with Lexie's family and friends wearing her favorite pink! The tenacity and compassion of these incredible advocates truly #takesmybreathaway


Smoking and Asthma

November is national Lung Cancer Awareness month! Smoking (and secondhand smoke!) can cause asthma flare-ups in kids and adults. Is today the day YOU quit smoking to improve your asthma? Find out why smoking is a bad idea - especially for people with asthma.


Thank you to all the patients, clinicians, and researchers who attended Setting the PaCE: Carolinas Symposium on Wednesday! It was a wonderful opportunity to connect and learn about engaging in primary care research. One attendee inspired us with his takeaway; that hearing and incorporating the patient voice is crucial to the future of healthcare!

Thank you to Ed Bujold and Ray Haeme of Granite Falls Family Medical Care Center and Hazel Tapp of Mecklenburg Area Partnership for Primary-Care Research for hosting. Thank you to founders and funders of the Patient and Clinician Engagement initiative: Patient-Centered Outcomes Research Institute - PCORI and NAPCRG-North American Primary Care Research Group.


We are so excited to host Ray Haeme and Dr. Ed Bujold for Setting the PaCE next Wednesday! If you are a patient or clinician interested in engaging with health research, join us for this FREE event. October 11, 10a-2pm, lunch is provided if you register using this link:

Dr. Edward Bujold along with Dr. Hazel Tapp and Ray Haeme will present a symposium on patient and clinician engagement on October 11, 2017. The event will be held from 10am-2pm at the Carolinas Medical Center-Mercy Auditorium (2001 Vail Ave, Charlotte, NC). Symposium topics will include the PaCE concept and background, primary care research, an introduction to PCORI, advocacy, patient engagement, how to form a patient advisory council and discussions on patient engagement in primary care research. 09/29/2017

Asthma Campers Learn about Air Quality - Clean Air Carolina

How cool is this?? Our friends at Clean Air Carolina were at Camp Open Airways last month helping kids with asthma learn about the disease and how to cope with everyday activities. Campers learned ways to protect air quality by conserving energy, carpooling, and having parents turn off their engines when waiting in lines.

Camp Open Airways is a program of the Jeff Gordon Children's Foundation, which is part of Carolinas HealthCare System. Feeling #CHSproud Clean Air Carolina was at Camp Open Airways in Kannapolis, NC this August leading a session on air quality education for 29 kids with asthma.


#SafetyFirst when viewing the eclipse on Monday! See below for more info on certified glasses or making your own pinhole projector. If you have small children likely to take their eclipse glasses off, please consider keeping them inside.

Looking for all the ways to safely watch Monday's #Eclipse2017? Look no further. We rounded them up here for you: 08/10/2017

September Asthma Epidemic

Back to School Shopping List:
spiral notebooks ✅
highlighters ✅
Asthma Action Plan 😱⁉️

Time to call your provider and schedule a visit! Make sure you are prepared BEFORE September scaries. Asthma and Allergy News and Research September Asthma Epidemic AAFA Community Services 9/26/167:39 PM Does your asthma or your child’s asthma always seem to get worse in September? If so, you’re not alone. In fact, researchers have studied this issue. Here is what they found.September is a difficu...


Is it really back to school time again?! We know that #asthma rates spike in September when school-aged kids are exposed to new allergens. One way to prepare for this kind of allergy season is to get vaccinated against the flu and pneumonia!

If your child has asthma, they should get both the flu and pneumococcal vaccines. These shots can go a long way toward keeping your child healthy this school year. Here are 5 reasons why they need these vaccines:

Need support managing your child's asthma at school? Join our online community where others will share their tips:


Asthma Australia

This is a great visualization of asthma in the lungs - check it out!

*Note: this video describes Rescue inhalers as "relievers" and Controller inhalers as "preventative medications"

Here's a great video from TED-Ed on asthma. There's even a great little multiple-choice test at the end to see how much you've learnt!

#asthma #whatisasthma


Patient-Centered Outcomes Research Institute - PCORI


Learn more about our new initiative designed to help patients work with their clinicians to choose the healthcare options best suited to their needs.


American College of Chest Physicians

Lifestyle changes -- diet, exercise, sleep and stress -- can affect your #asthma symptoms. If you are experiencing worsening asthma, or your asthma is becoming harder to control, discuss with your health-care provider how lifestyle changes may be impacting your symptoms. Learn more at


Atrium Health

Incredible news!! Carolinas HealthCare and Novant Health will now be sharing Electronic Medical Record (EMR) information.

What does this mean for our asthma patients? 🤔
If you visit your primary care provider in system A after being seen in the ER of system B for an asthma attack, your care team in system A will be able to see every record of the care you received by system B!! This reduces duplicate tests and procedures, reduces costs to patients, and improves accuracy and efficiency.

Emoji interpretation:
😷🤒🤕 + 🏨↔️🏩 = 😄🤗👏🏼

Have you heard the news?! We have a new agreement with Novant Health.


Did you know that the process to develop, test, and approve new medications takes an average of 9 years?! Check out this cool infographic about the drug approval process!

Courtesy of


Atrium Health

Happy #ClinicalTrialsDay! Check out this story about fantastic clinical research by our teammates at CHS​. We are so thankful for our patients who participate in clinical research to help improve their health AND the health of future patients! #OneTeam

Today is #ClinicalTrialsDay and we're sharing stories of the work we're doing advancing the science of care throughout the day.

Follow along, but first, read about Tasha and Caleb Wygal. After eight years of trying to conceive on their own, they got pregnant within three months of enrolling in an infertility trial.


Check out these awesome photos from the 2nd annual Asthma Walk! It was a beautiful day to raise #AsthmaAwareness. Thank you all for coming!! 🤗

📸: Takes My Breath Away

MCAC 2nd Asthma Walk-- Thank you to everyone who came to support us despite the weather conditions. I greatly appreciate you.


Want to learn about #asthma and controller versus rescue medications? Come to the free asthma walk this Saturday morning at UNCC and you can speak with people who are passionate about #improvingasthma! 04/17/2017

The Haven Project | NYRP

#EarthDay is this Saturday, April 22!

Here's why people with asthma (and their providers) care about the health of our beautiful planet: air pollution can trigger asthma attacks! Green spaces are even associated with LOWER rates of asthma. The New York Restoration Project is working to establish more green spaces to improve asthma. Awesome!


Did anyone else hear that Mecklenburg County is expecting SNOW on Sunday?!? We are pretty sure snowflakes are not on our list of common spring allergies 😜. After an early and extra warm kickoff to #allergyseason, this forecast seems right on target with the #climatechange evidence we have read about. How are YOU preventing spring allergies from affecting your #asthma?


Want to know what #takesmybreathaway? Our patients! We work hard to produce patient-centered research here at Elizabeth Family Medicine and could not do so without the valuable input and insight of our patients in Charlotte and across NC. We have asthma awareness advocates helping structure dissemination plans, patient caregivers advising on intervention design, and a whole board of patient advisors who assess and critique new documents and processes in the clinic. Thank YOU, patients of EFM, your passion and engagement is truly breathtaking!

In loving memory of Alexandrya, who inspired the #takesmybreathaway movement to increase #asthmaawareness.


It's almost March 5th! This Sunday, share your story and #takesmybreathaway to honor Alexandrya McCullum. Let's raise #asthmaawareness together!

Happy birthday, Lexie! Today, we are celebrating asthma research in your memory. You and your family inspire us every day to work harder and improve best practices for asthma treatment, so that no child with asthma will suffer your fate again. Your mother's mission to make a beautiful message out of the tragedy of your passing truly #takesmybreathaway.

Alexandrya McCullum, 3/5/97-1/30/05


The groundhog may have seen his shadow, but with a high of 72 degrees today we suspect spring - ahem, *allergy season* - is right around the corner! What are YOU doing to keep spring allergies from affecting your asthma? 02/10/2017

Thunderstorm asthma: report finds agencies failed to share information

Remember hearing about the devastating thunderstorm asthma in Australia last year? The Australian government is pledging to form an emergency plan that will improve communication and coordination of care for those affected. They hope to prevent future storms from impacting the health of their citizens with asthma. Way to go, Australia! Preliminary report into event that killed nine people in Melbourne finds emergency services responded well, despite failures in communications


Who's excited for the #superbowl?? 01/30/2017

The Heroism of Incremental Care

We believe that shared decision making and consistent visits with your primary care provider can help all patients manage their asthma so it stays under control. Often this slower-moving, incremental care is upstaged by in-the-moment life-saving actions (such as using a rescue inhaler). Here is a fabulous (though quite long) article describing the heroism of incremental care.

"...states with higher ratios of primary-care physicians have lower rates of general mortality, infant mortality, and mortality from specific conditions such as heart disease and stroke. Other studies found that people with a primary-care physician as their usual source of care had lower subsequent five-year mortality rates than others, regardless of their initial health...Likewise, reforms in California that provided all Medicaid recipients with primary-care physicians resulted in lower hospitalization rates. By contrast, private Medicare plans that increased co-payments for primary-care visits—and thereby reduced such visits—saw increased hospitalization rates. Further, the more complex a person’s medical needs are the greater the benefit of primary care." We devote vast resources to intensive, one-off procedures, while starving the kind of steady, intimate care that often helps people more. 01/24/2017

High Prices for Drugs With Generic Alternatives

New year, new insurance? Anyone experiencing changing coverage for asthma medications? If cost is the most important factor for your asthma control, ask your medical provider if there are other effective and inexpensive options.

Curious how some medications have increasing price tags despite availability of cheaper options? Check this out:
"To preserve the long-term financial stability of the health care system, the use of medications that provide high value to patients should be the priority, not high-priced drugs with generic alternatives." This Viewpoint examines the rising cost of prescription drugs using Duexis, a drug used to treat rheumatoid arthritis, osteoarthritis, and to decrease the risk of developing upper gastrointestinal ulcers, as an example.



Jacquie Halladay presented today at the Business of Health Care Convocation about Practice-Based Research highlighting some of her work on the costs of quality improvement in community-based practices. #bohcunc UNC School of Medicine UNC Cecil G. Sheps Center for Health Services Research North Carolina Translational and Clinical Sciences Institute UNC Family Medicine UNC Kenan-Flagler Business School


We hope you all had a safe and fun snow day!

Not all of our patients could go outside to play in the snow...but our team brought the snow inside and made the cutest little snowmen with them! ☃️❄️💙 01/05/2017

Winter Weather Advisory – Asthma, Cold Air and Exercise

Day 5: How are those resolutions coming? Don't let asthma keep you from exercising! Head indoors to a local gym or fitness studio, or sweat along with videos from an exercise mat in your living room.


American Lung Association

Still deciding on a New Year's resolution? How about quitting smoking?

“I’ve quit so many things in my life but quitting smoking was the hardest.” Hear Pamala’s #TheDayIQuit story on the EACH Breath Blog, and share your own in the comments below.


Happy New Year! Are you making any resolutions about improving your asthma? 12/28/2016

Seven to Watch | Rising star at Carolinas HealthCare finds her ‘dream job’

We interrupt our regularly scheduled programming to deliver this exciting development: Dr. Cole, a family physician at the practice that houses our research team, was honored by the Charlotte Observer! With her leadership, Carolinas HealthCare and Novant Health are collaborating to focus on six communities that have been identified by the county as “public health priority areas” because of characteristics such as high rates of diabetes, cancer, and asthma.

Way to go, Dr. Cole! Growing up in Dayton, Ohio, Alisahah Cole always knew she wanted to be a doctor. She treated her stuffed animals as patients and listened for their heartbeats with a Fisher-Price stethoscope. But she was disappointed when her kindergarten teacher suggested she should think about becoming a model or…




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