Pulmonology and Allergy Problematic Asthma (PAPA) Clinic

People with asthma have airways that are extra-sensitive to triggers that cause lung inflammation and narrowing of the airways. The triggers can include infections, allergens and irritants in the air. Sometimes asthma is hard to control and in certain cases might need multiple specialists to optimize care. The Pulmonology and Allergy Problematic Asthma (PAPA) Clinic serves infants, children and adolescents whose asthma is difficult to manage, requiring the coordinated and comprehensive care of pulmonary and allergy specialists.

Who we are

We are a team led by two physicians — Jeffrey Ewig, MD, attending pulmonologist, and Sigrid DaVeiga, MD, an attending allergist — with a nurse practitioner, Rose Stinson, MSN, CRNP, along with nurses, a social worker, psychologist and nutritionist who provide additional care and educational support.

What we do

At the PAPA clinic, children with asthma see the pulmonologist and the allergist together during their visit. This allows the medical team to address health concerns in a collaborative way. The doctors work together to identify other medical diagnoses that complicate care, identify triggers that patients might need to avoid, and optimize asthma and allergy control. This coordinated care simplifies scheduling for patients so that they do not need to make multiple appointments to see different relevant specialists.

At a PAPA clinic visit, a patient can expect to have pulmonary function testing completed and also might have skin testing completed to identify relevant allergens. Each visit also includes asthma education, inhaler technique training, and medication access support from the nurses on the team, to help the patient and the family manage all aspects of the asthma treatment.

Where needed, we coordinate care with other medical specialties, such as Endocrinology, Gastroenterology (GI) and Otolaryngology (ENT).

The combined team of specialists will communicate a collaborative plan to your child’s primary care provider, and we will provide support for your child’s primary asthma provider and other community-based care providers. When a patient’s asthma care is provided by a doctor who is not affiliated with Children’s Hospital of Philadelphia (CHOP), the Clinic team provides the doctor with diagnostic information from the Clinic visit and recommendations for ongoing treatment.

Who we treat

The PAPA Clinic is available to infants, children and adolescents who have severe or poorly controlled asthma. Patients suited for evaluation in the PAPA clinic have usually required multiple Emergency Department visits and hospitalizations for their asthma or their asthma is not controlled with standard guideline-based therapy. The clinic is open to patients whether or not they are already seen by a doctor within the CHOP system.

If you believe your child may benefit from the PAPA Clinic, please speak with your physician about a referral to the clinic or contact us directly. Call the PAPA clinic coordinator, Christina Johnson, at 215-590-6731.