350 Capitol Street, Room 514 • Charleston, WV 25301-3715
Phone: (304) 356-4193 Fax: (304) 558-1553

Asthma Management for Healthcare Providers

The West Virginia Asthma Education and Prevention Program recognizes and applauds the hardwork, time and effort that health care providers give everyday to improve the lives of their patients. 

The WVAEPP is here to aid you in by providing: easy and quick references of the National Heart Lung and Blood Institute (NHLBI), Guidelines for the Diagnosis and Treatment of Asthma Expert Panel Review 3 from 2007, as well as educational materials available online and by mail; access to our partners as part of the West Virginia Asthma Coalition, our partners in the WV Bureau for Public Health - specifically the Health Promotion & Chronic Disease Division, and the Centers for Disease Control and Prevention.  

The success of any effort to manage asthma rests solely upon the effort and dedication of the patient with asthma in self-managing their condition. Your ability as the healthcare provider to convey information, teach skills - such as how to identify asthma triggers, and recognizing signs & symptoms, giving inspiration to follow their Asthma Action Plan, and working with the patient as part of their health care team to make recommendations regarding treatment is needed for success.

  • an average patient only spends 0.02% of their life with a healthcare provider,
  • the care and adherence of a patient rests solely on the shoulders of that patient,
  • a health care provider's effort influences how well patients and families form a team approach for health,
  • your efforts help determine how well the patient assumes the ultimate responsibility for their own well-being and self-managed care.

Make asthma a health a concern, and hopefully the patient will too!

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Asthma Management 101

Clinical Activities for Providing Quality Asthma Care:

  1. Establish asthma diagnosis and classify severity of asthma.
  2. Schedule routine follow-up care:  at least 1-6 months and spirometry testing at least every year.
  3. Perform lung spirometry testing to assess lung function and airway reversibility using pre/post beta2-agonist testing. (to be performed at least once every two years)
  4. Assess need for referral to specialty care.
  5. Recommend measures to control asthma. Instruct patient (and/or child's family) on recognizing triggers of asthma, and signs and symptoms of an asthma episode. Provide the patient or child's family with easy to read materials such as the "Home Environment Asthma Checklist" (see below) to help identify and remove asthma triggers in the home.
  6. Treat and prevent co-morbid conditions including providing annual influenza (flu)  vaccination and pneumonia vaccination (if needed).
  7. Prescribe medications according to severity including appropriate medication delivery and monitoring devices.
  8. Monitor use of beta2-agonist drugs (bronchodilators) - re-evaluate patients using more than ONE metered dosed inhaler (MDI) canister per month.
  9. Develop a written Asthma Action Plan (Provide copies of the Asthma Action Plan to the child's school, daycare center, caregivers, and family).
  10. Provide routine maintenance on patient self-management. Have patient bring in inhaled medications - including metered dosed inhalers, dry powdered inhalers, diskus, and nebulizer; other delivery devices to include spacer and valved holding chambers; and monitoring devices such as a peak flow meter with each visit to ensure proper use and function of device.
  11. Track and monitor patients with asthma via a "disease patient registry system" or similar process to ensure improved care and adherence to medications and control. WVAEPP offers opportunities for rural health centers to achieve this goal. Contact us today to learn more - click here.

If the initial treatment fails to achieve adequate control of the patient’s asthma after 2-6 weeks, you should consider:

  • Checking the patient’s adherence to treatment (drug-taking compliance)
  • Checking the patient’s inhalation technique through direct observation by the physician or other appropriate medical staff
  • Re-evaluating the diagnosis: other differential diagnoses that may have to be considered include, for example, chronic obstructive pulmonary disease (COPD), airway narrowing by a tumor, vasculitis, and pulmonary embolism
  • Persistent exposure to toxic substances and allergens
  • Aggravating factors such as gastroesophageal reflux and chronic sinusitis.

Severity of Asthma changes slowly over time, 

           Control of Asthma changes quickly

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QUICK REFERENCE of National Guidelines 

National Heart Lung and Blood Institute EPR 3 - FULL REPORT (approx. 500 pages) Guidelines for the Diagnosis and Treatment of Asthma Expert Panel Report 2007  

ASTHMA Guidelines Trifold - WVAEPP's quick reference tool on the NHLBI Guidelines

Asthma Care Quick Reference - detailed 12 page quick reference of the NHBLI Guidelines

The GIP Report - 1 page reference of the key measures in the NHLBI Guidelines

NHLBI Guidelines Implementation Panel Report for the Expert Panel Report for the Diagnosis and Management of Asthma - GIP Report 2008: the key messages that will most likely result in significant impact on asthma care processes and outcomes.  

Additional References and CME/CEU Education

NIOSH CERTIFICATION - spirometry training and interpretation, pulmonary function testing quality assurance measures, and other respiratory equipment and measures.

Physician Asthma Care Education (PACE) - NHLBI's Asthma Program, a two-part interactive, web-based educational to improve physician awareness, ability, and use of communication and therapeutic techniques for reducing the effects of asthma on children and their families.  It also provides instruction on how to document, code, and improve asthma counseling reimbursement. 

National Asthma Control Initiative (NACI) - a multi-component, mobilizing, and action-oriented initiative. For fact sheet click here.

Asthma Treatment for Children is not "one size fits all" - the NIH article on BADGER THERAPY (Best ADd on therapy Giving Effective Responses)   

Billing, Coding, Reimbursement, and Return-on-Investment

Medicare Guidelines - a reference guide  

Asthma Return-on-Investment Calculator -  a tool to show the potential returns from quality improvement and disease management programs for populations diagnosed with asthma. This Asthma ROI Calculator provides estimates based on an analysis of 52 research studies on improving asthma care and what those studies imply for cost savings.  

Improving the Health Outcomes of Your Patients

Asthma Education Resources  

Asthma Medications, Dosages, Usage, and NHLBI Guidelines EPR3 Referencing  - Quick Reference Sheet

Asthma and other Respiratory Disease Medications 

Basic Steps on How to Perform Spirometry on a patient

Managing Asthma while Pregnant - Is asthma being masked during pregnancy?

NIOSH Spirometry Graph - what constitutes a good spirometry result? this descriptive poster explains the results

Pathophysiology of Asthma Graph - an outline of the relationship between airway inflammation, airway hyperresponsiveness, airway obstruction, and asthma symptoms.

Toolkit for Making Written Material Clear and Effective - The Toolkit is a health literacy resource from the Centers for Medicare and Medicaid Services (CMS). The 11-part Toolkit provides a detailed and comprehensive set of tools to help you make written material in printed formats easier for people to read, understand, and use. 

Educating the Patient and the Family 

Home Environment Asthma Checklist - Is your patient's home "asthma friendly"? Here is an easy to follow list and suggestions to improve the air quality of the home.  

Things a family can do to get ready for an "asthma" lung doctor visit - what questions to ask at the next visit

Learn about asthma - what is asthma? what are triggers? what can I do to prevent asthma episodes or attacks?

Patient Aerosol Guide - this how-to education guide explains the use of all types of inhalers and nebulized medications

Safe Cleaning for People with Asthma - educate your patients to learn safer ways to clean the home and office; easy cleaning and tips 

Environmental Health Issues and Resources

Pediatric Environmental Specialty Units - a network of experts in the field of children's environmental health. Online tutorials, presentations, and training opportunities available.

Web-based Training and CME/CEUs

takeACTION! interactive program - asthma and diabetes education for school personnel and others in wv. Available online (use included link) and via CD-ROM from the WVAEPP. CEUs are available. 

Association of Clinicians for the Underserved - multiple resources for the provider and patient

 

Asthma Education for the Healthcare Provider - CEU/CMEs available

 

Health Literacy Training for Health Professionals: Free Continuing Education   Limited health literacy affects nine out of ten adults and impacts their capacity to fully manage their health. To help public health professionals respond to limited health literacy, the Centers for Disease Control and Prevention (CDC) has launched a FREE, online training program: Health Literacy for Public Health Professionals  

Pediatric Environmental Home Assessment -  From the National Center for Healthy Housing. This program is for Public Health and Home Visiting Nurses. This course prepares nurses to:

  • Complete a pediatric environmental health history and recognize potential environmental hazards and sentinel illnesses as part of a primary prevention approach.
  • Recommend a course of preventative action or make appropriate referrals for conditions with probable environmental etiologies as appropriate for their discipline.  

Asthma Articles and Resources

A Call to Action Against Asthma - Journal of the National Medical Association

Asthma Action Plan (PDF) - NHLBI template  

Printable Brochures, Pamphlets, and Posters

The items in this section are available in printed color versions for free. Just contact  WVAEPP for your copies today by calling 304.365.4193. 

Facts on Asthma in West Virginia - certain groups of people are more adversely affected by asthma in the state versus nationwide, specifically children, women,  seniors, and those individuals of low socio-economic status.

Smoking and Your Health - trifold brochure for those with Asthma in WV

Tobacco Use & Asthma Trifold - Know the Risks in West Virginia

Asthma Trigger Banner

Together We Can Control Asthma Poster  

Secondhand Smoke, SIDS, and Asthma Flier

 

 

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