International Primary Care Respiratory Group

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      Spring into Action logoTop tips for family physicians to improve asthma control in their patient population

Action on smoking
Over one third of the adults with asthma surveyed were current smokers. This, to some extent, will sabotage all other efforts to control their asthma, so:
  • Consider putting a poster up in  your waiting room advising patients to ask for help to quit.  Download one from here.
  • Ask all patients whether they have used tobacco in the last 12 months.   Follow the “5 As” to guide you and the smoker through their quit attempt. Download a 2-side desktop helper here.
  • Reassess users at every clinic/call or at least once a year. This alone will double the rate of success.   
  • Document their smoking status/stage of motivation/tobacco burden in your records
  • Promote quitlines and other local support in your waiting room
  • Use World No Smoking Day posters and stickers to get the message to young people
Action on medication concordance
  • Explain to patients that asthma is a controllable condition and people can usually live a completely normal and active life if they agree and follow a plan 
  • Explain that it can take up to 18 months or more for lung function to return to normal with regular treatment and during this period the airways  remain irritable and vulnerable to further attacks
  • Test out descriptions of the mechanism of asthma with the patient until you find one that is understood
  • Avoid terms like “chronic” “incurable” that may not be understood or worse, create a sense of despair in the patient
  • Explain how the person with asthma can prevent attacks
  • Be familiar with the current guidelines: the Global Initiative for Asthma (GINA) guidelines changed little in 2007, but the 2006 guidelines contained an important change in approach to asthma management, placing the emphasis on assessing, treating, and monitoring patients based on level of asthma control rather than asthma severity.
  • The IPCRG asthma and allergic rhinitis management guidelines cover treatment goals and pharmacologic therapy for the two conditions. The asthma guidelines refer to two age groups, preschoolers and children (<6 yrs) and older children and adults. The allergic rhinitis guidelines, consistent with the ARIA guidelines, emphasize the link between asthma and allergic rhinitis.
Further reading: by primary care for primary care
  • Look out for our newsletter Exchanges on Asthma due out by the end of May 2008 that summarises new international guidelines and consensus statements on asthma and offers top tips from colleagues and patient representatives around the world. Contact us if you want a copy.
  • Read our paper online: Can asthma control be improved by understanding the patient's perspective? 
  • Look out for our follow-up paper to be submitted to Respiratory Medicine. Contact us if you want the reference.
Dr John Haughney, IPCRG president, UK
Siân Williams, IPCRG Executive Officer
Dr Ian Charlton, IPCRG, Australia

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Page updated on 28 April 2008

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