Asthma management service

A previous attempt to provide an asthma management service by a different pharmacy was considered an attack on physicians turf by one of the clinics. 

National Pharmaceutical Council (NPC). Disease Management Balancing Cost and Quality. An annotated bibliography of studies on the benefits of disease management services for the treatment of asthma. National Pharmaceutical Council, Reston, VA, 2002, pp. 1-51. 

FIGURE 80-2. Home management of acute asthma exacerbation. Patients at risk of asthma-related death should receive immediate clinical attention after initial treatment. Additional therapy may be required. (MDI, metered-dose inhaler PEF, peak expiratory flow.) (Adapted from NHLBI, National Asthma Education and Prevention Program, Expert Panel Report 2. Guidelines for the Diagnosis and Management of Asthma. NIH Publication No. 97-4051. Bethesda, MD U.S. Department of Health and Human Services, 1997.)... 

Second Expert Panel on Management of Asthma. Guidelines for the diagnosis and management of asthma. Bethesda, MD U.S. Department of Health and Human Services, Public Health Service, National Institutes of Health, National Heart, Lung and Blood Institute, 1997. 

Last year Dr. Brouchard s wife was offered a job opportunity in Phoenix. While he loved his job in Chicago, his wife s opportunity was too good to pass up, and he knew that there were plenty of pharmacist jobs in the Phoenix area. He arranged a transfer to another pharmacy in his chain that was located in Sun City (a suburb just northwest of Phoenix). When he arrived, he was anxious to further develop the pediatric services he had started in Chicago. He convinced his pharmacy manager to purchase special equipment to teach children how to monitor their asthma, to remodel the pharmacy to include a private counseling area, and to spend money promoting these services in the local community. 

The pharmacy already had a private counseling area, and he figured that he could use some of the resources he had obtained for the pediatric asthma service for a diabetes service. When he told his pharmacy manager about his idea, she seemed excited, especially given the potential for the service to attract new customers to the pharmacy. She did stress that her budget to support this service was limited and that he would have to provide more financial projections that she could share with her district manager before she could commit to support the service. 

Once it is determined which service is to be implemented, it is important to put some thought into what the service will look like and how it will be delivered at the practice. As discussed previously, regardless of the type of service (i.e., diabetes, lipids, asthma, etc.), the medication management processes used by pharmacists remain relatively the same. Some component of the service will require the pharmacist to collect patient clinical information, including laboratory data. The pharmacist also needs to assess the patient information that has been collected and make a clinical decision regarding the appropriateness of the therapy. Patient education is a component of each type of service but may be emphasized more so with certain services (e.g.,... 

Medicaid is supervised by CMS but is administered by each individual state. In Medicaid, each state determines the list of health care professionals who can be considered as providers. For pharmacists to be considered providers of patient care services for Medicaid, the state can develop a Medicaid demonstration project (Snella, 1999). One example of a demonstration project is the Mississippi Medicaid project in which pharmacists were compensated for services such as asthma, diabetes, and hyperlipidemia management (Anonymous, 1998 Landis, 1998). 

National Asthma ELdncation Program, National Institntes of Health. Gnidehnes for the Diagnosis and Management of Asthma. Pnblication No 91-3042. Bethesda United States Department of Health and Human Services, 1991. 

Pharmacists are providing DSM services to help patients manage such chronic diseases as asthma, diabetes, and dyslipidemia, and drug therapies such as anticoagulation. Hundreds of pharmacists, including those serv-... 

Children with asthma are major consumers of health services [33]. An average of 6.4% of the annual income of middle class families, and 10% of the income of low-income families, is spent for the management of childhood asthma in the USA [34]. Children with asthma miss school more frequently [35], make more visits to emergency departments and physician s offices [36], and spend more time in the hospital than healthy children [37]. Asthma has been linked to poor school performance [38, 39], especially among children of low socio-economic status [40]. Children with asthma also have problems related to poor psychological adjustment [41], low self-image [9(Ia)], and disruption of family life [32, 37]. The failure to diagnose asthma and the subsequent lack of adequate treatment [42] may cause morbidity later in adult life [43]. 

Topics addressed in the kit include mold, radon, secondhand smoke, asthma, portable classrooms, basic measurement equipment, hiring professional assistance, codes and regulations, and integrated pest management, as well as other typical indoor air pollutants and pollutants from motor vehicles and equipment. The program uses checklists for different job functions, e.g., facilities managers, teachers, nurses, food service workers, videos and awards programs, and fact sheets on major issues. 

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