Asthma Pharmacology Webinar: How Do I Apply To My Role?

Asthma Pharmacology Webinar: How Do I Apply To My Role?

This is a follow-up to the Asthma Series Webinar #2 covering the pharmacotherapy and step-wise approach to asthma management.
Some practical applications for the care team would be:

  1. Recognizing that patients with persistent asthma should be taking a maintenance or long-term medication and have available a quick-relief or rescue medication to take when they have exacerbations.
    All care team members can become familiar with the names of the medications used to control asthma and recognize patients frequency and use of maintenance and rescue medications. Having this knowledge can be used to explore how the patient is managing their asthma. If they are using the rescue meds frequently it would be important to inform the provider, as this would be an indication that the patient is not in control, and or, there is some type of barrier or concern of the patient requiring further exploration.
    Just like other chronic conditions, it can be difficult for the patient to accept they have the diagnosis of persistent asthma. Understanding the “Rules of Two” (slide 26) and exploring this with the patient may help them recognize if they are or are not in control. When it’s evident the patient is not in control, the door is open to exploring the reasons, and reinforcing the value of maintaining control.
  2. During patient visits at the clinic or in the home, an important action would include monitoring the level or class of control. The classes of control (slide 30) are; well controlled – not well controlled – very poor control. Based on the patients level of control helps determine the appropriate intervals for follow-up and monitoring.
  3. Included in the step-wise management actions is self-management (slides 31 & 32). One way of increasing self-management is partnering with the patient to create a self-management action plan. This is different than the asthma action plan. With the self-management action plan, we focus on goals and actions the patient identifies. The asthma action plan focuses on the medical management of asthma.
    Example of self-management action plan discussion:

    • “Based on today’s visit, your asthma is not well controlled. Dr. Smith is concerned with this and asked me to meet with you. I’d like to explore your ideas on how we could improve your asthma. What are some ideas you have?”
      If none – you could offer some ideas such as, taking medications, maintenance control, or attending appointments. “Now that I’ve shared these, do you have any ideas?”
      Once the patient identifies something they could do, get specific. Where, when and how. An example could look something like, “I’ll take my maintenance medications,” with a reply of, “This is good – let’s get specific.” To do this consider asking how many days of the week the patient can commit to taking the maintenance medications? When will they take them?
    • The action plan could then be: Improving asthma by taking maintenance medications at least 5 of the 7 days in the week.
    • Next: Assess the patients confidence with the plan. If less than a 7 on a scale of 0-10 explore the goal and if needed make adjustments.
    • Consider Exploring visual reminders or daily routines to assist the patient. A revised plan might be, “Improving asthma by taking maintenance medications every morning right after I have my coffee at least 5 of 7 days in the week.”
      The nurse, care managers and providers focus on the risk and safety issues and concerns of asthma. They will provide education to the patient on the importance of maintenance, the use, side effects and actions of medications and developing and using the asthma action plan. Based on their assessment findings, they will determine treat-to-target goals and when needed recognizing the need to intensify treatment.The CHW’s and MA’s can assist the patient by reinforcing the benefits of maintenance, partnering with a self-management action plan, recognizing when there are symptoms of not being in control and advising the provider, and exploring the barriers and as directed by the provider assisting with referrals to community organizations or helping the patient complete forms for indigent medication programs.

Click to view the recording & presentation slides

I hope you found the webinar useful to your work. Our goal is to support you, so you can support the patients you work with! We have links to some tools and resources that you may find helpful.


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