In the UBC Annual Report, Dr. Mark FitzGerald, Professor of Medicine and Head, Division of Respiratory Medicine at UBC and VGH, talks about gaining intercultural insight to communicate more effectively with asthma patients.

For many people, asthma is a disease that can be quite easily controlled through proper usage of medication and avoiding irritants. But if you don’t understand how to take your medication or what irritants to avoid, asthma can quickly become a very serious problem.

That was Dr. Mark FitzGerald’s concern when he realized that entire communities in Vancouver were not receiving the clear communication they needed. “Simply translating existing materials into other languages isn’t enough,” says Dr. FitzGerald, UBC Professor of Respiratory Medicine and Co-Director at the Institute for Heart and Lung Health. “We must take into account the attitudes and perspectives of the audience, which are sometimes quite different from those of the medical professionals who create the material.”

Rather than complain about the current material available, Dr. FitzGerald and Senior Health Evaluation Scientist Iraj Poureslami set out to create something better. Through focus groups within various ethnic communities they gained insights into what was missing in current communications and how to more effectively communicate and reach these groups.

The discoveries were surprising to say the least. Punjabis revealed that they are often inclined to hide their asthma because it’s associated with tuberculosis, a stigmatized disease in their culture. Chinese people expressed that they would be more willing to quit smoking if it is harming a loved one.

Armed with a stronger intercultural understanding, Dr. FitzGerald and Dr. Poureslami created ‘community videos’ in Punjabi, Cantonese and Mandarin featuring actual focus group participants as they acted out scenarios conveying messages about asthma management. Patients from these communities who watched the videos dramatically improved their inhaler skills and their understanding of the steps they needed to take to control their condition. The CIHR funded study showed significant improvement in patients ability to manage their asthma at the end of the study period.

“We’re not wasting their time with medical mumbo-jumbo,” says Dr. FitzGerald who sees asthma patients at Vancouver General Hospital’s Lung Centre. “We’re speaking in the patients’ own languages – not just linguistically, but culturally.”

See more from the UBC annual report

The Department of Medicine is very pleased to congratulate three of its department members; Dr. Jason Andrade, Dr. Andrew Krahn, and Dr. Kenneth Madden on a successful outcome in the 2013/2014 Heart and Stroke Foundation Grant-in-Aid peer-reviewed competition. UBC researchers received 8 of the total 102 awards distributed through the prestigious Grant-In-Aid program, which provides approximately $30 million per year in program support.

Jason Andrade, Clinical Assistant Professor of Cardiology studies atrial fibrillation (AF), the most common heart rhythm disorder which increases the risk of stroke and death and affects the quality of life of many Canadians. Despite advances in drug treatment, AF remains uncontrolled in many patients. In most cases, abnormal electrical impulses that set off AF come from the pulmonary veins, which carry blood from the lungs to the left upper chamber (atrium) of the heart. Catheter ablation, a procedure used to remove faulty electrical pathways, has been developed to cure AF. The procedure involves placing a catheter into the upper left chamber of the heart via the veins in the groin and then burning or freezing the heart tissue responsible for AF, potentially curing the arrhythmia.

Dr. Andrade, and his collaborators including Department of Medicine member, Anthony Tang, will investigate whether new procedures utilizing shorter durations of freezing are more effective and safer than procedures using longer freezing durations, or procedures using radiofrequency energy. The outcomes of this study have the potential to fundamentally change the way in which cardiac cryoablation is performed. If a superior efficacy with shorter freezing durations is shown it will result in improved procedural outcomes for patients undergoing AF ablation, resulting in a reduction in AF recurrences, as well as a reduction in arrhythmia related symptoms, hospitalizations, and health care utilization.

Cardiology Division Head, Andrew Krahn is a leading expert in the field of genetic heart arrhythmias and is working to create a nationwide network of clinics, able to diagnose and treat individuals born with inherited electrical abnormalities.  Approximately 30,000 Canadians die suddenly every year. Patients that are born with a genetic arrhythmia may experience abnormal heart racing resulting in blackouts or sudden death during childhood or adulthood. Identifying the cause and its implications for family members is paramount to preventing these tragedies.  The Canadian Genetic Hearth Rhythm Network, coordinated here at UBC, will study patients experiencing cardiac arrest and blackouts, 2 very common presentations of heart disease. Proper recognition and testing will save lives, particularly in otherwise healthy children and young adults that are at risk.

Kenneth Madden, Associate Professor in Geriatric Medicine received funding for a three year study examining “Acarbose and Older Adults with Postprandial Hypotension”. Fainting that leads to falls in older adults is a serious problem, the consequences of which include hip fractures, death and hospitalization. In a quarter of these adults, postprandial hypotension (PPH), a drop in blood pressure after a meal, is responsible for the fainting spells. Currently, there is no cure for PPH. This study will evaluate the use of acarbose, an anti-diabetic drug, to diminish PPH in older adults. Dr. Madden postulates that following a meal, the increased blood flow to the digestive system induces the blood pressure decrease, which decreases blood flow to the brain and causes the fainting. As acarbose slows digestion and carbohydrate breakdown, the drug shows promise in limiting the post-meal blood pressure reduction. In providing a possible cure for PPH, his research could improve the quality of life for older Canadian adults and result in cost savings of up to one billion dollars a year for the health care system.

The Department of Medicine is extremely proud of all the research endeavors of its investigators, as exemplified by these projects which seek to improve patient care, outcome and health policy not only here in British Columbia, but throughout  Canada.