asthma
ASTHMA
Asthma is a chronic inflammatory disease of the airways in the lungs of children and adults.
The patient usually complains of shortness of breath, chest tightness and coughing with wheezing.
Goals of treatment are effective symptom control with minimal or no exacerbations, minimal or no nocturnal and daytime symptoms, no limitations on activities, minimal or no need for reliever treatment, and minimal adverse effects of medication.

Asthma Patient Education

Patient Education

  • Goal: Increase understanding, skills, satisfaction and confidence to increase compliance and self-management of asthma
  • Develop partnership between healthcare professionals, patient and the patient’s family
  • Continual process to provide the patient and their family with appropriate information and training to allow the patient to remain well and modify therapy according to predetermined medication plan
    • Plan includes monitoring, a written asthma action plan containing specific information about medication and dosage changes based on symptoms and/or peak expiratory flow (PEF), when and how to access medical care, and regular follow-up
  • Education should be provided over several visits
    • Inquire also about patient’s compliance to the treatment plan and their ways of avoiding risk factors
  • Improve compliance: The patient is more likely to be compliant with medicine regimens if:
    • The diagnosis is accepted and the patient realizes that asthma can be dangerous or can be a problem
    • The patient believes the treatment is safe
    • The patient feels in control and there is good communication between the patient and provider
  • Healthcare professionals should help patients to recognize deterioration in asthma control and should educate patients to seek medical attention if:
    • There is severe asthma attack and respiratory distress (ie severe dyspnea, difficulty talking)
    • Reliever medication is needed more than every 4 hours and symptoms are still not improving

Self-monitoring

  • If possible and based on resources of the healthcare system, on the initial visit, concept of PEF monitoring may be introduced to the motivated patient
    • Patients with more than mild disease should receive training on how to measure and record PEF
  • Self-monitoring is not reliable in children
  • If PEF monitoring is not an option, patient should be educated to assess their status based on symptoms

Written Asthma Action Plan

  • May help patients recognize and respond appropriately to an asthma attack
  • Should include specific, individualized instructions about medications and medical care access
  • Changes to medications may include the following:
    • Increasing as-needed inhaled low-dose corticosteroid-Formoterol doses
    • The use of an inhaler containing rapid-onset long-acting beta2-agonist with low-dose corticosteroid
    • Other inhaled corticosteroids and inhaled corticosteroid-long-acting beta2-agonist maintenance controlled regimens
    • A short-course oral corticosteroids for patients unresponsive to increased doses of reliever and controller medications, rapid deterioration, PEF or FEV1 <60% of personal best, or a history of sudden severe exacerbations
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