Asthma Intervention. An Independent Licensee of the Blue Cross and Blue Shield Association.

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1 Asthma Intervention 1. Primary disease education Member will have an increased understanding of asthma and the classification by severity, the risks and the complications. Define asthma Explain how lungs work Provide education about disease process and associated risks Assess risk factors and co morbidities Reveal identifiable causes of asthma Explain classifications of severity (i.e., intermittent, mild persistent, moderate persistent, severe persistent) 2. Signs and symptoms / seeking medical attention Member will have increased understanding of warning signs and symptoms of asthma, when to contact their health care provider, and when to seek emergency treatment. Explain how to recognize signs and symptoms of asthma exacerbations such as coughing, chest tightness, wheezing and trouble breathing. Teach use of peak flow meter Explain asthma zone action plan: Green zone (safety) % of personal best Yellow zone (caution) 50-80% of personal best Red Zone (danger) below 50% of personal best Describe common asthma triggers: Environmental tobacco smoke, dust mites, outdoor air pollution, cockroach allergen, pets, mold, other triggers such as medications, weather, foods and food additives, and strenuous physical exercise. Talk about allergies Develop written action plan for asthma management Provide education for when to seek medical assistance/treatment 3. Role of medications Member will have increased understanding of the role medications play in the treatment of their chronic conditions. They also will have increased understanding of the types of drugs such and quick relief medications and controllers. Take medications Explain long-term control vs. quick relief medications Avoid medication triggers Explain how to use inhalers, nebulizers, spacers Explain proper care of drug delivery devices

2 4. Physical activity Member will be able to maintain regular physical activity level and gain knowledge about benefits of including regular exercise and physical activity in their daily routine. Assess for EIB (exercise-induced bronchoconstriction), provide advice to enable physical activity, and promote adherence to physician s restrictions and limitations Check with physician for appropriate exercise Check to see if member has other health conditions Explain why it is helpful to use quick-relief inhalers when exercising (only if prescribed) o Take medication before exercising Carry appropriate ID Explain why routine exercise is important (most days of the week) Explain benefits of physical activity Share tips on how to get started Describe different types of exercise 5. Healthy nutrition Member will increase knowledge about how to make smart food choices, and learn how eating in moderation can help achieve/maintain a healthy weight. Explain basics of healthy nutrition (unless there are other medical conditions) Assess if specific diet is recommended by physician Provide recommended food servings based on food pyramid (mypyramid.gov) Explain portion control Explain how to read nutritional facts on food labels Offer tips on how to avoid food triggers Discuss importance of moderate alcohol consumption 6. Self-care Member will gain an increased understanding of the importance of monitoring/keeping record of key points to control their asthma. Keep diary of signs and symptoms Keep diary of peak flow readings Explain importance of peak flow monitoring Share tips on how to avoiding triggers Discuss role of medication Explain co-morbid conditions (i.e., rhinitis, sinusitis, GERD, COPD) Determine exposures and sensitivities, including environmental and occupational triggers Review ways to reduce exposure to allergens and irritants that provoke asthma symptoms

3 Discuss smoking avoidance for those who smoke or is exposed to environmental tobacco smoke 7. Preventive care and maintenance Member will have an increased understanding of the benefits of preventive care and regular maintenance of all body systems. Carry quick relief inhaler when exercising Follow up with physician on regular basis Recommend influenza and pneumococcal vaccines (per physician and/or CDC guidelines) Discuss how weather factors into asthma Review injury prevention techniques (i.e., good hand washing) Explain why it is important to use of medication prior to allergen exposure Preventative maintenance card Monitor and keep diary to record symptoms and triggers Assess members smoking status Provide smoking cessation education as needed Review importance of drug therapy Teach lifestyle interventions o American Cancer Society recommends an annual mammogram for women age 40 and older. o American Cancer Society recommends an annual PSA test for men age 50 and older. 8. Weight management - Member will gain an increased understanding regarding appropriate weight reduction methods and learn the importance of achieving/maintaining recommended BMI. Recommend member who has elevated BMI to discuss weight reduction with their physician Assess members interest in weight management Provide support and education to members actively engaged in weight reduction Review exercise guidelines 9. Safety Member will increase knowledge of how to manage asthma to avoid risk of injury/death. Carry asthma identification/medical alert at all times Discuss importance of support person knowing what to do in an emergency Discuss medication compliance Provide education about prevention of recurrent exacerbations of asthma

4 10. Long-term lifestyle modification Member will be encouraged to continue lifestyle modifications. Identify barriers that challenge required behavior changes Develop strategies to respond to these barriers Avoid situations that make it hard to change Encourage and support small steps 11. Psychosocial To assess member for signs and symptoms of depression and lack of social contact and provide referral for screening and social opportunities. Identify self as having asthma Identify family support Identify affects of asthma on lifestyle Assess for signs and symptoms of depression Assist with managing stress Offer resources available for psychosocial support (i.e., mental health screening, family, support groups, counseling) Non FEP members may call or visit and take a confidential, self-administered depression screening FEP members may call or visit to inquire about treatment options and benefits. 12. Working with health care team Member will be encouraged to ask appropriate questions regarding health and lab values, concerns about asthma, treatment expectations, quality of life issues, and compliance with health care plan. Explain how physician and health care providers will work together as a team Explain how health care team will help member understand asthma Encourage member to be an active participant in health care decisions Include tips to help interact with physician and health care provider: o Tell them how you feel o Keep physician and health care provider informed of tx plan and S&S o Ask questions if/when they don't understand o Keep diary of peak flow results o Know your action plan 13. Travel Member will be encouraged to plan ahead for travel and have necessary medications and treatment devices with him/her.

5 Plan ahead of time for weather and environment conditions Don t forget to take your peak flow meter Bring your medications when you travel Use air conditioning instead of open window (if possible) Ask for non-smoking rooms in hotels and rental cars Resources: See list on resources page. September 2006 Revised: December 2008 Revised: April 2011 Reviewed: April 2012 Dr. Myron Leinwetter, MD April 30, 2012 Date

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