Asthma patient education

Clark NM, Feldman CH, Evans D, Duzey O, Levison MJ, Wasilewski Y, et al Managing better Parents, children and asthma. Patient Educ Counsel 1986 8 27-38. 

Takabayashi K, Tomita M, Tsumoto S, Suzuki T Computer-assisted instructions for patients with bronchial asthma. Patient Educ Couns 1999 38 241-248. 

Osman LM. How do patients views about medication affect their self-management plans in asthma Patient Educ Counsel 1997 32 S43-S49. 

Develop a patient education plan that fits the patient s needs. Educate about the differences between the asthmatic and normal lung and what happens to the lung during an asthma attack. Counsel the patient on how their medications work and differentiate between longterm control and quick relief medications. 

Prepare a patient-specific self-monitoring plan and review it with the patient. Educate the patient on the signs and symptoms of asthma deterioration and when and how to take rescue actions. 

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.,... 

The pharmacists of Care-Rite Pharmacy also developed patient educational tools to be used during the patient assessment and patient education components of the Pharmacy Check-up Service. Because many of the targeted patients have similar medical conditions, education materials were developed for specific disease states, including hypertension, ischemic heart disease, diabetes, asthma, chronic obstructive pulmonary disease (COPD), etc. Also, educational materials were developed for certain therapeutic classes of medications. The Care-Rite pharmacists also determined that many patients needed individualized education materials, so they implemented a drug information/educational service as part of the MTM service. With this service, patients can ask questions regarding their medical conditions and/or drug therapies. The pharmacists will research and provide an individualized written response for each patient. 

Gibson, P. G., Coughlan, J., Wilson, A. J., Hensley, M. J., Abramson, M., Bauman, A., and Walters, E. H. (2004). Limited (information only) patient education programs for adults with asthma (Cochrane Review). In Barlow, J. H., Ellard, D. R. Psycho-educational interventions for children. Child Care Health Dev. 30(6), 637-645. 

Patient education is vital for the management of asthma. Patients should be guided in their use of the asthma inhaler. It is important that you then observe the patient s use. Instructions given to the patient are as follows ... 

An asthma DM program can assist pharmacists in providing education to patients with asthma. Hunter and Bryant developed an educational intervention administered by pharmacists and targeted at pediatric asthma patients and their parents. The educational intervention consisted of a 45-min presentation, a demonstration of drug delivery devices, and a discussion session for participants to ask questions and share experiences. All the participants indicated on a questionnaire that they had received enough information to safely and effectively administer asthma medications. 

There is general agreement that there are four key components to asthma care assessment and monitoring pharmacotherapy control of environmental factors which exacerbate asthma, and patient education [2(NC)]. 

Taggart VS, Zuckerman AE, Sly RM, Steinmueller C, Newman G, O Brien RW, Schneider S, Bellanti JA You Can Control Asthma Evaluation of an asthma education program for hospitalized inner-city children. Patient Educ Couns 1991 17 35-47. 

Gallefoss F, Bakke PS, Rsgaard PK Quality of life assessment after patient education in a randomized controlled study on asthma and chronic obstructive pulmonary disease. Am J Respir Crit Care Med 1999 159 812-817. 

Wilson-Pessano SR, McNabb WL The role of patient education in the management of childhood asthma. Prev Med 1985 14 670-687. 

Gupta SK, Sen Mazumdar K, Gupta S, Sen Mazumdar A, Gupta S Patient education programme in bronchial asthma in India Why. how, what and where to communicate Indian. 1 Chest Dis Allied Sci 1998 40 117-124. 

Hilton S, Sibbald Ii. Anderson HR, Freeling P Controlled evaluation of the effects of patient education on asthma morbidity in general practice. Lancet 1986 i 26—29. 

Liljas B, Lahdensuo A Is asthma self-management cost-effective (review) Patient Educ Couns 1997 32 S97-S104. (NC)... 

Patient education regarding precipitants of allergic symptoms, asthma, and anaphylaxis is essential. Guided self-management to prevent, assess and treat symptoms is the key to optimising disease control (A). 

Cote J, Cartier A, Malo JL, Rouleau M, Boulet LP. Compliance with peak expiratory flow monitoring in home management of asthma. Chest 1998 113 968-972. Roter D, HaU J, Katz N. Patient-physician communication a descriptive summary of the literature. Patient Educ Counsel 1988 12 99-119. 

In the USA, LTRAs have largely replaced theophylline as the incremental drug for the treatment of moderate and severe asthma, where LABA plus ICS alone do not provide adequate control. For patients with mild persistent asthma, LTRAs have been designated as a suitable substitute for low dose ICS by the National Asthma Education Panel Program (NAEPP) of the National Heart and Lung Institute (National Institutes of Health). However, inhaled ICS are more efficacious. 

Once diagnosed, patients with AlA should avoid aspirin and any other NSAIDs strongly inhibiting COX-1 their education is of utmost importance. They should receive a list of contraindicated and well-tolerated analgesics (table 2). Even topical administration (intravascular or by iontophoresis) of a NSAID may cause an asthma attack and should be avoided. 

Educate patients on the use of inhaled drug delivery devices, peak flow monitors, and asthma education plans. 

Because of the significance of the event, patients may be more open to education about asthma after resolution of the exacerbation. Health care professionals should use this opportunity to provide information to help prevent future episodes, including recognition of early indicators of an exacerbation and a process to appropriately intensify pharmacotherapy during the early stages of future exacerbations, including an individualized written asthma action plan. 

Patients must understand the role of long-term control and quick relief medications in their asthma treatment plan. The importance of understanding asthma as a chronic disease and the need for daily treatment with long-term control medications should be stressed. Additionally, the importance of proper use of medication delivery devices should be continually reinforced. Basic education should be provided over several visits with the health care provider. 

Patients sensitive to specific allergens should be educated on ways to avoid them. Environmental controls to reduce the allergen load in the patient s home may reduce asthma symptoms, school absences because of asthma, and unscheduled clinic and emergency visits for asthma.13 Patients allergic to warm-blooded pets should remove them from the home if possible or at least keep them out of the bedroom. However, allergens may remain in the home for months after the pet is removed.1... 

Monitor patient use of long-term control medications to ensure adherence to the medication plan. Patients not adhering to the long-term control medication regimen should be re-educated on the importance of these medications for asthma control. 

Other printed materials can be used alone or in conjunction with oral education. Newsletters are published regularly and can be used to convey information addressing specific treatment issues. For example, a newsletter article might address current treatment approaches for pediatric asthma. Because newsletters also contain information that may be of general interest to practitioners and patients, they can have broad exposure. Brochures and booklets can be used to communicate a focused message in an efficient manner. These materials typically are given to people who are expected to have an interest in the topic within. 

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.)... 

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