Overview of Asthma Treatment

1
Overview of Asthma Treatment

• Creating a Medical Home for Asthma
• Session 1

2
Right after I finish the history and examination,
I look directly at the patient and family and ask
Now what really concerns you about asthma?

• This is a quick, effective way to find out what
  concerns the patient or family.
• You can then quickly deal with their fears,
  relaxing them so they can concentrate on what you
  say.
• Patients are often embarrassed to say what
  worries them most.
• Having dealt with their concerns, if I think they
  have asthma, this is what I tell them.

3
Im going to explain this to you the same way I
do with patients

• We know enough about how to treat asthma so that
  your child can live a normal life. That means
• Participation in active sports
• Sleeping through the night
• This reassures the family and establishes the
  goals of treatment.
• Then I say, asthma is a special kind of
  bronchitis with recurring episodes in which the
  airways swell and are blocked.

4
What happens in your lungs when you have asthma?

• Its similar to what happens to your nose when
  you have a cold
• Your nasal passages swell and secrete mucus so
  that you have difficulty breathing through the
  clogged nose.
• With asthma, your airways also swell, secrete
  mucus, and clog, making it harder to breathe.
• This is what we call inflammation and it can last
  for 6-8 weeks after a bad cold.

5
What happens in your lungs when you have asthma?

• When your airways are inflamed, they are very
  sensitive to anything that irritates them.
• Muscles around the airways squeeze them partly
  shut, thus narrowing the airways still further
  and making it difficult to breathe.
• This is called bronchospasm. Many people think
  this is all there is to asthma and do not realize
  the importance of ongoing airway inflammation.

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What are the symptoms of asthma?

• Wheeze
• Persistent cough
• lasting 2-3 weeks after a cold
• beginning with exercise
• Chest tightness and/or shortness of breath

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How can you tell if a child has asthma?

• In the first 5 years of life we cant tell the
  bronchitis that becomes asthma from the
  bronchitis that doesnt, but we treat it in
  exactly the same way.
• Clinicians have several different terms to
  describe wheezing in the early years of life,
  including
• Asthma
• Bronchitis
• Wheezy bronchitis
• Reactive Airways Disease

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Triggers that make asthma flare up

• Respiratory infectionscold or flu
• A cold that doesnt go away is probably asthma
• Colds and flu are the common triggers for asthma
  in children under three
• Exercise
• Allergiesrare until the age of three
• Irritantstobacco smoke
• Seasonal changes in weather

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Treatment Strategy--Prevention

• When airways are inflamed, daily treatment with
  anti-inflammatory medicine is needed to reduce
  the swelling, mucus, and irritation.
• Airways are chronically inflamed when
• Symptoms occur 3 or more days a week
• The child wakes at night with symptoms 3 or more
  times a month
• Children are having colds more than once every
  two months

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Treatment Strategy--Prevention

• When attacks or flare-ups do occur, we treat them
  immediately to keep them from getting worse
• We use bronchodilator medications that provide
  quick relief by opening up the airways.
• Bronchodilators dont stop the inflammationfor
  that you need controller medications that
  suppress the inflammation.
• Treat asthma like a firewhen you see smoke,
  dont wait to see what happensput the fire out.

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The Team Approach To Preventive Control Of Asthma

• Each staff member has a role in creating a
  medical home for asthma that grows out of the
  work they do with families.
• All staff in the office
• Can understand and discuss the main messages
  about controlling asthma with families
• Can observe and assess how families think and
  feel about their childs asthma and treatment
• Can share their observations with other staff who
  need to know

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The Team Approach.

• Learning how the family feels is necessary
• To see if the treatment plan is workable
• To address barriers to adherence the family is
  facing
• To assess if treatment is working and make
  adjustments
• All staff should take time to
• Make the family feel comfortable
• Listen to the familys concerns
• Make sure the family understands the treatment
  plan

13
The Team Approach.

• Families should know
• The name of the medicine and how it works
• How to take medicines correctly
• How to follow the written treatment plan
• What should be done in an emergency
• That it is important to have regular scheduled
  appointments to monitor control of asthma and
  adjust the treatment plan
• That you want to hear if the treatment plan is or
  isnt working

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The Team Approach.

• By following these steps and working together as
  a team, you can help families
• Bring up and discuss problems they have managing
  asthma
• Become partners with you in controlling asthma
• This is what we mean by creating a medical home
  for asthma.