RE: [BULK] Asthma etc check out sheets

[Guest guest]

the thing is--

that is not written at a readin g level most people can or WILL BOTHER

to study.

The IDEA you promote with check out sheets is education, individialized,

indiviual plans and progress measurement

which is of course excellently fabulous

Can accomlish the same with the simple problem solving sheets from the iMP

cohorts:

then it is genereic:( makes an easy template in an emr)

what do you want to accomplish by the next visit?

How convinced are you this si the rigth thing for you?

waht are the steps to take to reach the goal

what will get in the way

what can you do about the things that can get in t he way

How confidetn are you you can reach the goal.

The trick is if the oal is THEIRS not OURS then they get there.

[bULK] Asthma check out sheet

Importance: Low

I have a few asthma patients who are using sooooo much albuterol!

I keep reinforcing the goal of using it for rescue only and here is

my rendition of an asthma check out sheet which is reinforcing

WHY I suggest what I do in the way of care. I also waive co-pays

for the financially strapped IF THEY PROMISE to get a peak flow meter

and it has worked! Yipppeee!

Pamela

Asthma Care - Meet Your Goals

Asthma can be a debilitating illness in the Willamette Valley.

Understand your triggers, don't smoke, treat underlying allergies

and heartburn so you can control your illness, enjoy your life and

avoid lengthy doctor visits and hospitalizations. Purchase a peak flow

meter and track your progress at home so you can prevent serious

asthma attacks.

How are YOU doing?

Daytime symptoms Nighttime symptoms Spirometry/Peak Flow

Mild Intermittent < 2 x wk < 2 x mo FEV1 > 80%

Mild Persistent > 2 x wk, < 1 x day > 2 x mo FEV1> 80%

Moderate Persistent daily > 1 x wk 60-80%

Severe Persistent Continual Frequent < 60%

Goals of therapy: To control symptoms and normalize pulmonary function

with minimal use of short acting inhaled beta2 agonists

(albuterol/proventil)

Medications:

Inhaled steroids are the mainstay of treatment if you have mild

persistent

or worse asthma. These are every day medications that prevent the need

for short acting or rescue meds. Inhaled mast cell stabilizers

(Cromolyn/Intal MDI or Nedocromil/Tilade) can be use to decrease

inflammation. Leukotriene Inhibitors (Singulair or Accolade) are oral

tablets that can decrease inflammation. Methylxanthines such as caffeine

or theophylline (dose needs to be monitored) can open the airways. Long

acting inhaled beta2 agonists such as serevent can be helpful at opening

airways and last longer than short acting meds such as albuterol. If you

can control asthma with the above medications in the right combination

you should rarely need your short acting beta2 agonist

albuterol/proventil

which is a rescue medicine that should be reserved more for emergencies.

Oral steroids are the last resort for severe asthma and can have serious

side effects if taken for an extended period.

*AVOID ibuprofen and aspirin products as these can cause asthma

attacks!*

Health Care Maintenance:

complete physical pap mammogram dental exam vision exam

labs cholesterol prostate thyroid blood count

colonoscopy (more fun than it sounds) spirometry/peak flow meter

Immunizations LCPHD 682-4042 Tetanus, Tdap, Influenza yearly ,

Pneumoccocal (at time of diagnosis and revaccinate once after

5 years if > 65 years old)

Follow Up Appointment: _____________________ or please call

___ Uncontrolled Asthma 1 wk 2 wk 3 wk 4 wk

___ Somewhat Controlled Asthma 2 mo 3 mo

___ Well Controlled Asthma 6 mo 12 mo

Please ensure you have enough medications until your next visit

Questions? Call Dr. Wible 345-2437