About 13 years ago, when Geoffrey Chupp, MD, was training to be a doctor, his 18-month-old son, Billy, was diagnosed with asthma. “I remember so vividly seeing him standing next to the bed, short of breath, wheezing,” Chupp recalls. Parental concern merged with professional curiosity, and Chupp, who had long been interested in immunology, found his calling. “Asthma really piqued my interest, and I had this desire to do something about it,” he says.
The center, which opened in 2002, is housed in the Winchester Chest Clinic at Yale-New Haven Hospital, and is staffed by a dedicated team of ear, nose and throat, gastrointestinal, pulmonary and allergy specialists.
Serving a major need
The only dedicated adult asthma center between Boston and New York, YCAAD receives more than 3,000 patient visits a year and is the hub of Yale’s program for clinical/translational research. YCAAD treats adults, starting with teenagers (typically young athletes who need help maximizing their performance while managing their asthma) up through patients in their 80s.
New Haven is an ideal location for the clinic, Chupp says, because of the large number of people afflicted with asthma. “Close to 10 percent of the population has the disease, and if you add in allergies and other airways diseases, it’s even higher,” he says. “So we’re talking about a major need for specialty evaluation and management of patients.”
When patients come to the clinic, they are evaluated by a physician, who reviews their medical history and records. Pulmonary function is measured and, if necessary, blood work and a CT scan are ordered. Specialists, including an allergist and a gastroenterologist, are available to examine the patient. If physicians suspect that something in the patient’s environment – dust, mold, cleansers or second-hand cigarette smoke – is causing the illness, home and workplace inspections are conducted. Once a treatment has been developed and put into effect, they closely monitor the patient’s progress.
Novel treatments for complex cases
“A multidisciplinary clinic enhances the quality of care,” Chupp says. “It provides an intellectual environment that puts all the physicians working on the patient in the same place at the same time.”
That intellectual environment also means YCAAD has become a hub of bench and clinical research into airways disease. Since the clinic opened its doors, about 500 patients have signed up to participate in clinical trials, and Chupp recently received a $3.2 million grant to identify the molecules that drive the severity of the disease.
“If we just give our patients the same medication every other pulmonologist has, then we’re just kicking the can down the road,” Chupp says. “It’s critical as an academic medical center to not only provide standard treatments, but also novel ones, ones that are just coming out of the pipeline.”
Focus on personalized care
Lauren Cohn, MD, YCAAD’s associate director, treats patients as well as conducts research in immunology and asthma. Cohn says a lot of what they do at the clinic is “undiagnosing” asthma. “People think that everything that wheezes is asthma, but often it’s something else, and every patient is subtly different. Our goal is to personalize our patients’ treatment regimens.”
Key to meeting that goal is a steady stream of patients coming to the clinic with respiratory ailments who want to participate in clinical trials. On that score, Chupp is confident YCAAD is fulfilling its mission.
“My approach is Field of Dreams: if we build it they will come,” he says. “And that’s what I’m finding. We’re getting referrals; walk-ins come to us and say, ‘I want to be evaluated.’ It’s really starting to take hold.”
To contact the Yale Center for Asthma and Airways Disease, please call 203-785-4198.