1. Asthma Education for Families and HCPs
Sarah Latham
Senior Paediatric Respiratory Nurse Specialist

2. Aim of asthma education
To instill confidence in parents/children in how to manage their asthma
To ensure child is on appropriate level of day to day treatment to lead a normal life

3. Aim of asthma education
To try to instill confidence in parents/children in managing asthma
To ensure child is on appropriate level of treatment to lead normal life

4. NRAD Inadequate inhaled corticosteroid (ICS) use
Inadequate objective monitoring of asthma
Inadequate follow-up
Inadequate use of written asthma plans

5. NRAD Increased use of salbutamol reliever
if ≥ 12 salbutamol inhalers prescribed over previous 12 months review needed
Increased risk of death within a month of discharge from hospital following acute asthma attack
follow-up at primary care essential

6. How long is an asthma attack?
Most asthma attacks severe enough for eventual hospitalisation develop relatively slowly over a period of ≥ 6 hours
In one study > 80% developed over 48 hours
Kolbe et al Thorax 1998:53

7. When/where to deliver asthma education
Acute asthma attack
Follow up appointment
Home visit
School

8. Acute asthma attack BTS Asthma Care Bundle TAPES
For adults and children from age 2 yrs admitted to hospital with acute asthma
TAPES
Technique and medication + Action Plan + Environment + Subsequent Care

9. BTS Asthma Care Bundle Inhaler technique check Medication check
Written asthma action plan
Triggers NB include smoking status
Subsequent care

10. Follow-up
Explore parental/child management of recent asthma attack prior to seeking medical help
Reiterate salient points of asthma management, referring to written plan, inhaler technique
Lung function/allergic status

11. Inhaler technique 30 % asthma patients have poor inhaler technique
Poor inhaler technique associated with worse asthma outcomes
Gilette et al 2016
77% patients with good inhaler technique in clinic had partially effective/poor technique at home
Shields et al 2018

12. Home Visit
Systematic evaluation required for children and young people with persisting symptoms of asthma on high dose treatment
including identifying the mechanism of the persisting symptoms and assessment of adherence to therapy
BTS Asthma Guideline 2016
home visits by specialist respiratory nurse key part of assessment

13. School
Asthma education in schools led to improvements in symptom control and QOL but no impact on healthcare use
Directly observed therapy (DOT) improved symptom control
BTS/SIGN Asthma Guideline 2016

14. School
Multifaceted intervention combining education of school children with additional training for their doctor led to improved symptom control, QOL and reduced ED attendance and hospitalisation
Bruzzese et al 2010

15. determines the outcome
Non-Concordance
Patient’s expectation
Doctor’s/nurse’s opinion
The relationship
determines the outcome
Agreed management plan

16. Asthma education for HCPs
Education for Health
Tel
Courses at levels 5, 6 and 7
cover both adult and childhood asthma
Workshops
“Introduction to Paediatric Asthma”
21st June 2019
15 places left!

17. Thank you!