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The Michigan Asthma Resource Kit (MARK) has many handouts that can help your patients better understand and manage their asthma, including information about medications, triggers, devices and health insurance.
Recommendations for Initial Visit
Focus on:
| Teach or review in simple language | Teach or review and demonstrate |
| Assessment questions | Information | Skills |
|---|---|---|
“What worries you most about your asthma?” “What do you want to get done at this visit?” “What activities does your asthma keep you from doing?” “What do you expect from treatment?” “What medicines have you tried?” “Do you take your quick-relief inhaler more than two times a week?” “Do you awaken at night with asthma symptoms more than two times a month?” “Do you refill your quick-relief inhaler more than two times a year?” “What other questions do you have for me today?” Complete Asthma Control Test (ACT) at each visit. The Rules of Two is a registered trademark of the Baylor Health Care System. | What is asthma? A chronic lung disease. The airways are very sensitive. They become inflamed and narrow, making breathing difficult. Asthma treatments: two types of medicines may be needed:
Bring all medicines and devices to every appointment When to seek medical advice. Provide appropriate telephone number. The Asthma Control Test (ACT) is a validated objective measurement of the level of asthma control:
| Inhaler and spacer use. Check performance every visit (ask patient to bring medication and devices to every visit) Self-monitoring skills that are part of an Asthma Action Plan:
Use of a simple, written Asthma Action Plan. |
Recommendations for First Follow-Up Visit (2-4 Weeks or Sooner as Needed)
Focus on:
| Teach or review in simple language | Teach or review and demonstrate |
| Assessment questions | Information | Skills |
|---|---|---|
Ask relevant questions from previous visits and also ask: “What medicines are you taking?” “How and when are you taking them?” “Show me how you use your inhaler(s) and devices.” “What problems have you had using your medicines?” “Please show me how you use your inhaler or nebulizer.” | Use of two types of medicines. Remind patient to bring all medicines and the peak flow meter to every appointment for review. Self-evaluation of progress in asthma control using symptoms and peak flow as a guide. | Use of a daily Asthma Action Plan. Review and adjust as needed. Peak flow monitoring and daily diary recording. Correct inhaler and spacer technique. |
Recommendations for Second Follow-Up
Focus on:
| Teach or review in simple language | Teach or review and demonstrate |
| Assessment questions | Information | Skills |
|---|---|---|
Ask relevant questions from previous visits and also ask: “Have you noticed anything in your home, work, or school that makes your asthma worse?” “Tell me how you know when to call your doctor or go to the hospital for asthma care.” “What questions do you have about your Action Plan? Can we make it easier?” “Are your medicines causing you any problems?” | Relevant environmental control/avoidance strategies.
Review all medicines. Review and interpret peak flow measures and symptom scores from daily diary. | Inhaler/spacer/holding chamber technique. Peak flow technique. Use of the Action Plan. Confirm that patient knows what to do if asthma gets worse |
Recommendations for Subsequent Visits
Focus on:
| Teach or review in simple language | Teach or review and demonstrate |
| Assessment questions | Information | Skills |
|---|---|---|
Ask relevant questions from previous visits and also ask: “How have you tried to control things that make your asthma worse?” “Please show me how you use your inhaler or nebulizer.” | Review and reinforce all:
Review and interpret from diary:
| Inhaler/spacer technique Peak flow technique Use of daily self-management plan Review and adjust as needed Use of the Action Plan. Periodically review and adjust the written Action Plan. |