Allercy and Asthma Health
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Spring 2007

Hey! Keep it Clean in There

New Guidelines Will Help You Breathe Easy

Pharmacology and Delivery Devices: What Works Best for Your Patient?

Asthma Management: Barriers to Care

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The Official Publication of AAN - MA

New Guidelines Will Help You Breathe Easy

Chicken soup, cigarettes, and coffee have all been cures through the ages for the asthma patient. Sitting by a fan in the cool breeze will offer relief. Air breathed in through a jug of honey by the nose will lessen your symptoms. And lemon juice with pepper will keep asthma attacks at bay. Or how about eating a live fish stuffed with special herbs?

All of these have been proposed as asthma remedies. And while none of those treatments will hurt you (except the cigarettes, of course), they won’t help you manage, control, and live with your asthma on a long-term basis.

Luckily the government’s National Asthma Education and Prevention Program (NAEPP) can because their guidelines about the management of asthma have been the definitive source for asthma care and treatment for ten years. In 2007, these guidelines are undergoing their third revision and this document should serve as your major roadmap to successful asthma management for years to come.

It’s a document likely to be widely read by the health care community, but you need to know about it too. Your knowledge of the asthma guidelines can be your key to better treatment. Why? Because now that you know about these guidelines you need to ask your doctor two things:

1. Do you have a copy of the latest NAEPP guidelines?
2. Will you use the NAEPP guidelines in my care?

The NAEPP Guidelines—Why You Need to Know
While the NAEPP guidelines are meant to be used by health care providers, it is important that you, as a consumer of health care services, be aware of their existence. These guidelines are the definitive source for asthma care information.

The NAEPP is set to publish the newest version of the asthma guidelines this summer. The big, long name of this document is Full Report of the Expert Panel: Guidelines for the Diagnosis and Management of Asthma. In some circles, the lingo has already shortened the name to the EP3 Report because it’s the third revision of guidelines issued by an Expert Panel on asthma. It’s all the same thing.

The first guidelines were published in 1997 and have influenced the way physicians and other health care providers have treated and educated their patients with asthma. In a nutshell these guidelines reflect the latest information on asthma: what causes it, how it is diagnosed, how it is treated, and what patients need to know about their asthma, based on scientific evidence. 

The EP3 Report will summarize what we have learned about asthma over the past ten years. It is likely to change some aspects of how asthma is classified, recommendations for treatment. and how patients are educated.

Digging Deeper—What Do the Guidelines Say?
The asthma treatment guidelines are meant to be a road map for diagnosing, treating and avoiding severe asthma symptoms. They give the health care provider tools to use. 

In summary, the guidelines:
1. Explain how to tell if breathing symptoms are asthma and what tests to use to get the correct diagnosis. In this report, health care practitioners are told what diagnostic tools work best. These are tests that you should have annually.

2. Classify asthma by how severe the symptoms are by how often they occur. In the EP3 Report a new classification system has emerged to rate asthma for its severity and risk. This is something you should have done.

3. Recommend medication(s) based on the classification (mild–severe). Many new medications have emerged since the first printing of this report 10 years ago. This is one of the areas of the report that has changed the most. Medications will be dispensed based on your classification.

4. Suggest the best way to educate the patient on their asthma and medication and how the health care provider should make an action plan for patients to use if their symptoms worsen. The lesson from the first report still holds true:  each patient should have an asthma management plan. The EP3 Report stresses this again. So, if you don’t yet have an asthma plan, use this book as your excuse to ask your doctor.

How You Can Help Your Providers Manage Your Asthma Better
They are not hard and fast rules that can’t be changed. Your physician, based on her experience and knowledge and how your asthma symptoms respond to treatment, may take a different approach, but the EP3 report is a good place to start when first treating asthma. 

You need to do your part, too. Each time you visit your physician be prepared to give him information that can help design a better asthma management plan for you. Your answers and feedback will help the provider, based on the guidelines, to consider other methods for controlling your asthma symptoms.

Be honest with your health care provider. If you are having symptoms more often than once a week you need to let her know. Are you using your relief medicine more than two times a week? Are you waking up at night with breathing problems? There may be other medication options that can be considered. But they can only be considered if talk straight with your physician.

Do you have trouble taking your medication? For example if you are forgetting to take your medication during the day, your provider may be able to find a medication that is used less often. If your medication is too expensive, your provider may be able to change your medication or help you get it through the pharmaceutical company if you qualify.

You, too, have an obligation to stay on top of your asthma-related diagnosis. Be sure you have the answers to these questions by asking your physician:

  • How is my asthma classified by the guidelines?
  • What do my peak flow or pulmonary function numbers mean about my asthma?
  • What medication options are best for me and why?
  • Can we review my action plan to make sure I understand what to do if my symptoms worsen?
  • Can you please watch me take my inhalers to make sure I am doing them correctly?

It all boils down to this:  two-way communication is key, and the EP3 can help guide your physician into new approaches and information.

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