The successful management and treatment of asthma is a shared responsibility. It requires:
A. Integrated Patient Care
The best approach to asthma management in the community involves a team of health professionals working together across many settings. Patient care needs to be integrated by increasing consistent communication between professionals about the management of asthma in individuals and their families. The success of integrated care requires that people with asthma will have access to, and be able to afford, quality asthma management consistent with the standards set in the Asthma Management Plan.
Proposed Targets
3.1 The establishment of communications/organisational systems across health and non-health sectors regarding asthma management.
3.2 The fostering of liaison between general practitioners, pharmacists, specialists and asthma educators to improve patient care.
3.3 Affordable access on a convenient local basis to asthma medications, self monitoring and administration devices, and to expertise on their correct use.
Implementation Targets
3.4 An improvement in the communications between the hospital and health professionals in the community.
B. Team Asthma Management
Appropriate therapeutic management requires that patients be actively involved in determining their asthma management plan. This should significantly improve the way they use drugs and generally manage their asthma. Making the right choice for the individual may require that doctors and other health professionals adopt a range of health and behavioural interventions and strategies. These will be directed toward improving self-monitoring behaviour, encouraging collaborative management and increasing adherence to action plans and to preventive therapy.
Specific Targets
3.5 An increase of more than 50% in the proportion of all people with asthma who have a written action plan by the year 2000 from the current 17% of children and 14% of adults (Bauman et al, 1992).
3.6 An increase in the use of preventive maintenance therapy from 45% among children with persistent asthma (asthma symptoms more than twice a week) in 1990 to 80% by 1996 and 36.5% among adults with diagnosed asthma in 1990 to 80% by 1996 (Bauman et al, 1992).
Proposed Targets
3.7 An increase in the proportion of people with persistent asthma who visit their doctor every three months for review.
3.8 An increase in the proportion of those with moderate or severe asthma who have their action plan with them at all times.
3.9 An increase in the early recognition of asthma attacks by people with asthma.
3.10 An increase in adherence to written asthma management plans by people with asthma.
3.11 An increase in the proportion of those with exercise induced asthma who use medication correctly prior to exercise.
3.12 An increase in the proportion of people with moderate to severe asthma who always have a bronchodilator inhaler with them.
3.13 An increase in the number of people who participate in the development of their written asthma management plan with their general practitioner.
3.14 An increase in the proportion of health professionals, hospitals, emergency departments and general practitioners who manage asthma in accordance with NAC guidelines.
3.15 An increase in the proportion of people with asthma who, where appropriate, own and effectively use a peak flow meter.
Implementation Targets
3.16 The incorporation of accepted guidelines for asthma management into professional practice statements for health professionals.
3.17 The adherence of health professionals to the agreed best practice guidelines.
Outcome Measures
3.18 The identification of factors which influence optimal adherence to asthma management plans.
3.19 Measurement of the elements of the Asthma Management Plan to determine their effectiveness in controlling asthma.
3.20 Measurement of the effectiveness of people with asthma adhering to elements of the Asthma Management Plan to determine its effectiveness upon health outcomes.
C. Asthma Education
Health professionals, people with asthma, their carers and the general community need ongoing asthma education. All members of the asthma management team must have current information on asthma on a regular basis. Initial training courses and continuing education courses for health professionals must include asthma management. Mass communication strategies must be employed to reach all sections of the community to raise awareness of asthma and to convey the correct messages on asthma management to people with asthma and their carers.
Proposed Targets
3.21 An increase in the awareness of asthma and its significance to the community.
3.22 An increase in the proportion of health professionals who will be effectively trained in the principles of asthma management and education and undertake on-going continuing education.
3.23 An increase in the proportion of asthma patients and their carers with effective training in asthma management and in the optimum use of medication and devices.
3.24 A decrease in the proportion of people with asthma who are discriminated against because of their disease.
3.25 An increase in the number of people with asthma who are given correct and relevant information about their disease.
3.26 An increase in awareness in people with asthma and their carers that the reduced quality of life imposed by asthma is largely preventable.
Implementation Targets
3.27 An increase in the level of support for asthma education in all sectors.
3.28 An increase in the number of schools and relevant organisations which have adopted the principles of the National Asthma Schools policy.
3.29 An increase in the number of doctors and pharmacists who provide advice and ongoing care to patients when prescribing or dispensing medication.
3.30 An increase in the understanding of the role of preventer versus reliever medications by people with asthma and their carers.
3.31 An increase in the teaching of asthma management with reference to this goals and targets document.
3.32 An increase in the proportion of people with asthma who are offered asthma education after admission to hospital or attendance at Accident and Emergency.
3.33 An increase in the proportion of time devoted to asthma education in teacher training and professional development.
3.34 An increase in the proportion of teachers willing and able to administer asthma medication in appropriate circumstances to children.
Outcome Measures
3.34 The identification of information, attitude and management needs of different groups of people with asthma and their carers.
3.35 The identification of successful teaching methods and resources for asthma education.
Content Updated 1994
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