Course Goal and Objectives

The goal of this EQIPP course is to address quality improvement strategies to improve practices’ methods to diagnose and help patients and families manage asthma.

During the initial visit in which a diagnosis of asthma is considered:

• Consider a diagnosis of asthma if key indicators are present. The presence of multiple key indicators increases the probability of a diagnosis of asthma.
• Perform/attempt spirometry if the child is 5 years or older to confirm the diagnosis of asthma. (Also see Special Considerations for Diagnosing Asthma in Young Children.)
• Classify asthma severity (intermittent, mild persistent, moderate persistent, severe persistent) to guide initial treatment.
• Use a stepwise approach and the age-appropriate tables from current guidelines to identify initial treatment options based on asthma severity.
• Create a written asthma action plan in partnership with the patient/family to inform how to recognize and respond to worsening asthma. Education and skill training are essential to support the written plan.

For regularly scheduled follow-up visits and ongoing asthma management:

• Use a validated tool to determine the current level of asthma control.
• Identify and address reasons for loss of asthma control such as exposure to triggers, uncontrolled comorbidities, social determinants of health, and/or medication nonadherence
• Obtain/attempt spirometry measurements at least every 1–2 years for patients 5 years or older and more frequently if asthma is not well controlled.
• Adjust or maintain therapy using the age-appropriate stepwise approach based on the current level of asthma control.
• Administer/recommend an annual flu shot, as viral infections are a common precipitant of asthma symptoms.
• Update or maintain the written action plan and review with the patient/family to ensure understanding of the plan. Reinforce with education and skill training.
• Schedule the next in-office follow-up appointment as appropriate to monitor asthma control, depending on concerns and severity of disease.