Chronic Asthma- Counseling, Nonpharm Options

Question 1

What to discuss with the patient for controller options

Answer 1

Preferred treatment for symptom control and risk reduction

Predictors of risk or response

Personal goals and concerns

Inhaler technique, adherence, cost

Question 2

4 Cs of inhaler counseling

Answer 2

Choose, check, correct, confirm

Question 3

Inhaler counseling: choose

Answer 3

Choose an appropriate device before prescribing,

Consider medication options, arthritis, patient skills, and cost.

Also use a spacer for ICS by pMDI.

Avoid multiple different inhaler types if possible

Question 4

Inhaler counseling: check

Answer 4

Check technique at every opportunity, identify errors with a device-specific checklist

Question 5

Inhaler counseling: correct

Answer 5

give a physical demonstration on how to use an inhaler correctly

Question 6

Inhaler counseling: confirm

Answer 6

touchback method

Question 7

3 components of guided setf-management education

Answer 7

Self-monitoring if symptoms and/or PEF

written asthma action plan

regular medical review

Question 8

Nonpharm options

Answer 8

Avoidance of tobacco smoke exposure

Physical activity

Occupational asthma? Ask about work history and remove sensitizers ASAP

Avoid medications that can worsen asthma (NSAIDs, beta-blockers)

Get rid of mold/dampness in home

SLIT

Vaccines!

Inactivated influenza vaccine
COVID-19
Pneumococcal
Tdap (probably)