Patient-Centered Asthma Care
Providing guideline-driven, top-notch asthma care and improving the quality of life for every person who lives with asthma should be the goal of health care professionals treating asthma patients. Clinical guidelines give health care providers the tools and information they need to diagnose, treat, and teach effective self-management skills to their patients and their families.
Asthma care is a partnership and a shared responsibility between the patient, the health care provider, and the systems supporting them. Asthma can be controlled through effective asthma management using the guiding principles of patient-centered care 1
- Building patient’s knowledge and skills - Ensuring access to basic health information at an appropriate literacy level, access to educational opportunities to develop self-management skills and supporting the patient’s ability to actively participate in their care.
- Healthcare delivery systems - Ensuring access to safe, effective, culturally appropriate guideline-driven care that measures and reacts to patient outcomes using up to date technology within the patient’s medical home.
- Utilizing Community Systems – Understanding that the patient’s environment (e.g. home, workplace, school) greatly influences their health and ability to control their asthma. This involves identifying and referring to community-based services that address the educational, environmental, social and cultural needs of patients. These are not replacements for clinic based services, but rather effective tools that support successful and high quality asthma care.
Using the patient-centered care model approach, The National Asthma Education & Prevention Program (NAEPP) identifies specific components of asthma care:
- Assess and monitor asthma severity and control, and step up or down treatment intensity accordingly.
- Educate for a partnership in care by working directly with the patient/family to provide asthma self-management education and to develop a written asthma action plan.
- Identify, control or remove environmental asthma triggers.
- Address, identify and treat comorbid and other health conditions that can affect the patient’s asthma.
- Prescribe appropriate asthma medications, monitor their use and any side effects and make adjustments as needed.
Use Written Asthma Action Plans
Asthma action plans (AAPs) are written, individualized self-management and educational tools that provide daily and emergency guidance to asthma patients, parents, and caregivers at home, school, and the workplace and community settings.
Sample Asthma Action Plans
- Child - English (PDF)
- Child-Spanish/Niño español (PDF)
- Adult - English (PDF)
- Adult Spanish/Adulto español (PDF)
Sample Consent to Share forms:
MDH Educational Tools
- Asthma Triggers Sheet - English (PDF) – identifies asthma triggers and what a person with asthma can do to reduce those triggers.
- interactive Asthma Action Plan (iAAP) – developed by the MDH Asthma Program, this clinical decision support tool is now recommended for use by educational and health care systems to teach prescribing health professionals (MD, NP, PA, Pharm) how to assess an individual patient’s level of asthma control or severity based on the EPR-3 domains of impairment and risk. The interactive process helps the user to determine and select an appropriate treatment plan based on symptom categorization and select medication regimens appropriate for the level of control or severity determined. The information is pushed onto a pre-formed AAP and offers printable educational materials for documentation and education. This application contains a medication database that offers the majority of asthma medications (inhalers/oral) available but is no longer recommended for clinical use due to missing medication options. This is an educational tool only.
Asthma Home-Based Services
Health care systems, clinics, and providers struggle with sufficient time to provide asthma education in the clinic setting and they don’t have the opportunity to see what triggers may be affecting their patient’s asthma in the patient home. Home visits can provide asthma care that meets the medical and educational needs of the individual patient. Medical treatment, including daily medications in addition to effective management of asthma environmental triggers in the home, can reduce the number and severity of an individual’s asthma episodes.
Projects conducted by MDH have repeatedly demonstrated the effectiveness of home-based services that include both asthma self-management education and home environmental assessments for people with asthma.
- Asthma Home-Based Services Toolkit -Provides resources and educational tools to support Local Public Health (LPH) or other health-based organizations interested in developing an asthma home-based service program. Peer to peer mentoring is available, by pairing up experienced LPH staff with agencies that are interested in providing asthma home-based services in their community.
- Past MDH Demonstration Projects - Provides good examples of home visiting service models developed by Minnesota local public health agencies with support from the MDH Asthma Program. Demonstration projects provide the evidence behind home visiting services, how they happen and what the impact could look like in differing communities.
- Minnesota Programs Offering Home-Based Services - Contact information and a brief overview of current programs that offer in-home services for asthma.
“Work-related asthma is a lung disease caused or made worse by exposures to substances in the workplace. Common exposures include chemicals, dust, mold, animals, and plants. Exposure can occur from both inhalation (breathing) and skin contact. Asthma symptoms may start at work or within several hours after leaving work and may occur with no clear pattern. People who never had asthma can develop asthma due to workplace exposures. People who have had asthma for years may find that their condition can worsen due to workplace exposures. Both of these situations are considered work-related asthma. Early diagnosis and treatment of work-related asthma can lead to a better health outcome”.2
Learn more about Work-related Asthma.
Become a Certified Asthma Educator (AE-C)
The American Lung Association of Minnesota (ALAMN) offers training courses for health professionals who want to work towards becoming a Certified Asthma Educator (AE-C).
- The Asthma Educator Institute (AEI) is a two-day professional education preparatory course for healthcare professionals (RN, NP, RT, MD, PA, Pharm etc.) who want to implement asthma guidelines-based care and prepare to take the National Asthma Education Certification Board (NAECB) examination to become an AE-C. The curriculum covers the detailed content outline in the NAECB Candidate Handbook and includes case reviews, hands-on skills demonstration and practice. The course is delivered by asthma experts, including Certified Asthma Educators (AE-C), respiratory therapists, nurse practitioners, physicians, health educators and pharmacists. Continuing Education Contact hours are available that meet AE-C recertification requirements. Contact ALAMN at 651-223-9565 for future course dates.
- Lung Force Expo – held yearly, these expos are a great opportunity for health professionals to learn more about the latest trends, resources and research surrounding asthma and other lung diseases. The one-day event features experts in asthma presenting information on current hot topics, an exhibitor showcase and chance for professionals to connect with the local medical community. Continuing Education Contact hours (CEU/CME) are available to meet AE-C recertification requirements. Contact ALAMN at 651-223-9565 for future dates.
- The Association of Asthma Educators (AAE) offers courses designed in accordance with the NHLBI/NAEPP EPR-3 Asthma Guidelines. Continuing education credits are offered for live and online courses for a variety of professional disciplines. This membership-driven, national organization also offers in-person onsite training workshops appropriate for health care organizations/systems utilizing an evidence-based curriculum. They also offer a NAECB prep and recertification review course for those interested in sitting for their AE-C. Contact the AAE at firstname.lastname@example.org
State, National, and Global Guidelines
National Heart, Lung, and Blood Institute – National Asthma Education & Prevention Program (NAEPP)
Expert Panel Report (EPR-3) Guidelines for the Diagnosis and Management of Asthma
The NAEPP Guidelines are the nation’s gold standard for asthma care and management. These guidelines offer evidence and expert opinion-based recommendations defining how to manage asthma through comprehensive assessment, diagnosis, treatment and monitoring individual patient’s asthma. These guidelines detail the use of control medications like inhaled corticosteroids, the important components of a written action plan that guide patient asthma self-management, the importance of scheduling regular follow-up visits with a health care provider, and the impact and control of environmental triggers that can worsen the patient’s asthma. There are two versions available for download – the full guidelines and a 2007 summary report.
Global Initiative for Asthma (GINA)
2018 GINA Report, Global Strategy for Asthma Management and Prevention
Launched in 1993, GINA works in collaboration with the National Heart, Lung, and Blood Institute, and National Institutes of Health, USA, and the World Health Organization. GINA works with health care professionals and public health officials around the world to reduce asthma prevalence, morbidity, and mortality. The 2018 update of the Global Strategy for Asthma Management and Prevention incorporates new scientific information about asthma based on a review of recent scientific literature by an international panel of experts on the GINA Science Committee. This comprehensive and practical resource about one of the most common chronic lung diseases worldwide contains extensive citations from the scientific literature and forms the basis for other GINA documents and programs.
Institute for Clinical Systems Improvement (ICSI)
Institute for Clinical Systems Improvement – ICSI
The ICSI Diagnosis and Management of Asthma guideline work group endorsed 2016 Global Strategy for Asthma Management and Prevention Report with added qualifications/comments. The 2016 report addresses the diagnosis and management of asthma in the pediatric and adult population. The previous ICSI Diagnosis and Management of Asthma guideline from July 2012 has been retired.
National Environmental Education Foundation (NEEF)
Environmental Management of Pediatric Asthma
These guidelines for health care providers focus on integrating environmental management of asthma into pediatric health care. The guidelines outline competencies in environmental health relevant to pediatric asthma that should be integrated into routine asthma care by health care providers. The guidelines also provide details about environmental intervention recommendations that should be shared with patients as part of a clinical asthma visit.
Online Learning for Health Professionals
- Asthma Management and Education (AME-O) This online course is presented by The Asthma and Allergy Foundation of America (AAFA) for health care professionals who teach and care for patients with asthma. The content follows the NAEPP 2007 EPR-3 National Guidelines. The course has 11 lessons and four exams that you complete at your own pace. This program has been approved for 8.7 contact hours.
- Asthma Basics Offered by the American Lung Association, this is a FREE one-hour interactive online learning module for frontline healthcare professionals like school nurses, CHW’s and others who want to learn about asthma. The course links to resources including an overview of medication devices and demonstration videos.
- Indoor Air Pollution: An Introduction for Health Professionals Provided by the US Environmental Protection Agency (EPA), this document assists primary care providers in the diagnosis of patient symptoms that could be related to indoor air pollution. It addresses the health issues that can be caused by contaminants that may be encountered in the home, office or school setting.
- Particle Pollution and Your Patient’s Health Another educational opportunity provided by the US Environmental Protection Agency (EPA), this evidence-based training is designed for primary care providers, and other health professionals working with asthma patients.
- Asthma – Motivational Interviewing Online Course A one-hour (1 CEU) online learning module for health professionals, this course was developed through a collaboration with Saint Paul College and the MDH Asthma Program. The self-paced course teaches motivational interviewing strategies to expand the viewer’s knowledge of the four components of asthma motivational interview.
- Online Asthma Courses Offered by the National Jewish Health, Office of Professional Education – multiple rotating courses focusing on asthma offer CME/CEU’s for health professionals. Educational credits are free but you do need to register for an account.
- Reducing Environmental Triggers of Asthma in the Home Developed by the Minnesota Department of Health Asthma Program, the 40-minute learning module was developed to educate Public Health Nurses how to perform a home environmental assessment as a component of delivering home asthma services. A resources section is included.
1 Experts from ‘Guidelines Implementation Panel Report’: EPR-3 – Guidelines for the diagnosis and management of asthma; Partners Putting Guidelines Into Action (PDF).
2Do You Have Work-Related Asthma? OSHA Factsheet (PDF) - Work-Related Asthma Occupational Safety and Health Administration