Asthma Diagnosis Explanation

Question 1

What is the rough structure that you can use

Answer 1

1. Information sharing
Brief history
Understanding
Concerns
Explanation (NWCPM)
Summarise

2. Explaining disease
Normal physiology, anatomy
What is the disease
Cause
Problems, complications
Management

Question 2

How would you start the consultation

Answer 2

Brief history

• what brings them in
• symptoms

Risk factors

• FHx - atopic triad
• smoking
• occupational exposures

Question 3

Gauge their understanding, how would you do this

Answer 3

What is your understanding of your symptoms?
Are there any aspects that worry you?
What would be the best outcome for you from today?

Question 4

How would you explain a condition

-N

Answer 4

Normal anatomy and physiology

• when you breathe in, air moves into your lungs via a branching network of hollow tubes
• at the end, oxygen can move into your blood and supply your whole body

Question 5

How would you explain a condition

-W

Answer 5

What is asthma?
-a common condition that affects the lungs which can make the hollow tubes narrower, making it harder for air to move into this branching network

-wheeze, SOB, chest tightness, cough

Question 6

How would you explain a condition

-C

Answer 6

Causes

• triggers that you’ve mentioned can irritate your airways causing them to get narrower
• if your airways are narrower, it makes it harder for oxygen to get deep into your lungs => SOB, rapid breathing, chest tightness, wheeze

Trigger

• dust, hayfever, food allergies
• cold, exertion, stress
• smoke and pollution
• lung infections

Question 7

How would you explain a condition

-P

Answer 7

Problems

• if you feel SOB and wheezy even when you’re using your inhalers as discussed
• if you experience symptoms that are impacting your day to day function, have a persistent cough at night or your peak flow is lower than normal => contact your GP so we can adjust your management plan
• Sometimes you can develop a sudden worsening of your symptoms where your inhalers do not help
• This can be life threatening and is an asthma attack => seek urgent medical help, call 999

Question 8

How would you explain a condition

-M

Answer 8

Aims of management

• No daytime symptoms
• No waking up at night due to symptoms
• No attacks
• No limitations on day to day activities
• Minimal med SE

We will come up with a personalised treatment plan together but a typical plan consists of

• prescribing a preventer inhaler that will be used when waking up and before bed to prevent symptoms developing
• prescribing a reliever that will relieve symptoms that you experience
• additional treatments like extra inhalers and tablets if your asthma isn’t controlled by your current treatment
• a peak flow meter that will help you monitor your breathing
• making sure that you are up to date with vaccinations
• regular follow ups to see how you’re doing, whether we need to make any adjustments

Question 9

Closing the consultation

Answer 9

So today we have discussed

• your experiences with asthma and your triggers
• how your lungs normally should work and what happens in asthma
• the symptoms you might get
• how we might manage it
• what you should do if your symptoms get worse progressively or if they are not relieved with your inhalers

Do you have any questions at this stage, there is a lot of information?

If you would like further information

• NHS page on asthma
• Asthma UK

You’re more than welcome to contact us if you have any other concerns