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“I hear what you’re saying”: Asthma Education and Control |
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Asthma Education: Opening the door to effective communication
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| Oregon Asthma Resource Bank |
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Print Materials
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| Development of the Oregon Asthma Resourcebank |
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References
iNational Asthma Education and Prevention Program 1997, Expert Panel Report 2: Guidelines for the Diagnosis and Management of Asthma, National Institutes of Health pub no. 97-4051, Bethesda, MD.
iiGlascoe, FP, Oberklaid, PF, Dworkin, PH, Trimm, F. Brief Approaches to Educating Patients and Parents in Primary Care. Pediatrics 1998 June; 101(6). Available: http://pediatrics.aappublications.org/
iiiJanson, JL, Fahy, JV, Covington, JK, Paul, SM, Gold, WM, Boushey, HA. Effects of Individual Self-Management Education on Clinical, Biological, and Adherence Outcomes in Asthma. The Am J Med 2003 December; 115: 620-626.
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This Issue 
References for this publication are available upon request.
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"We know a lot about asthma and have a lot of tools to diagnose and treat it, especially in its acute phase. These successes cover up our shortcomings in caring for the disease when it is not in crisis. Asthma is a chronic disease - we should anticipate that denial will affect some of our patients but it should not get the best of us.”
John Santa, MD
Assistant Director for Health Projects
Center for Evidence-based Policy
Department of Public Health and
Preventive Medicine
Oregon Health and Science University
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“I hear what you’re saying”: Asthma Education and Control
Asthma is a chronic, yet manageable disease. When people manage their asthma well, they can lead normal, active lives and experience few, if any, symptoms. Yet, despite evidence-based guidelines, gold-standard asthma medications, and promising self-management practices available, a startling percentage of people with asthma in Oregon are experiencing severe and uncontrolled asthma symptoms.
For the past six years, the Oregon Asthma Program has been collecting asthma data from various health plans in Oregon on the use of health care resources and medications for insured Oregonians with asthma. Additionally, the Oregon Asthma Program has partnered with health plans and primary care practices to conduct patient surveys and medical chart reviews. All together, these data tell a story of confusion and inconsistencies.
Health plan data reveal that one-third of all people with asthma are not using daily inhaled corticosteroids, and another one-third are over using their rescue medication. Similarly striking, at least half of respondents to the Oregon Survey of Adult Asthma (2002) who reported that their asthma is under control also reported experiencing limitations due to their asthma, including being awakened at night, having an asthma attack, or having symptoms of wheezing, chest tightness, shortness of breath, coughing, or phlegm, two or more days a week (See Chart ).
These findings indicate there is a disconnect between what people perceive as controlled asthma and control that meets the National Asthma Education and Prevention Program’s (NAEPP)i standard of control. They also suggest that people with asthma in Oregon may not realize that they can feel better. If this is the case, then access to quality asthma information may play a significant role. There are a number of possible reasons why patients may not be well informed about their asthma. For example, patients may not understand or be aware of what good asthma control is, while providers may not have enough time within a typical office visit to educate patients on how to control their asthma.
The responsibility for improving the ability of people with asthma to manage their disease does not just fall on the patient, or just on the provider. Both play an important role in reaching the common goal of well controlled asthma. Providers need opportunities and support to improve their skills and knowledge in helping patients better manage their asthma. Equally important, patients need reliable clinical and community-based resources to help them better understand their asthma and to know what questions to ask their health care team.
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