Breathe Easier

On ALL of our Proactive Care Checklists we have a care gap that triggers on patients in our Asthma Registry who have been identified as having persistent Asthma. I am personally very familiar with this care gap as I am a member of our Persistent Asthma Registry. Which basically means I didn't do a great job of using my controller medications and relied heavily upon my rescue inhaler. The only comforting fact, though a little discouraging from an asthma control perspective, is that I am not alone.

The Persistent Asthma care gap will trigger at every four weeks as long as the member fits the "persistent"Asthma criteria. Regular asthma patients who are in control do not need to be assessed the way our persistent and chronic asthma patients do. One of the questions I get is why ask so frequently? I can tell you from my own experience as an asthma patient, I can be in control one day and out of control the next. Some times all it requires is a minor adjustment to my medication, other times a breathing treatment is needed or steroids if it is really bad. Asthma patients who are used to dealing with asthma symptoms often think we are in control, when we aren't. What I contribute to an irritating cough and just deal with, is a signal to my physician that there may be something else going on. 

One time, a co-worker who shares the same PCP as me went in for a visit. My coworker commented to our PCP that I was "driving her crazy with my coughing". That night, my PCP called me to, as she put it, "listen to me breathe" over the phone. I thought she was crazy, but couldn't get out a full sentence without coughing. She asked me if I was using my Qvar controller medication. Which I said I had been.  Which is when she busted me by using a Medication Adherence tool which OUR team developed that clearly showed I hadn't refilled my prescription in MONTHS.  She made me come in the next day to be evaluated. I explained that the Qvar gave me laryngitis, even though I swished and rinsed every time. She switched me to another medication and that I take religiously which has helped me maintain control of my asthma. It's important to know if our members are in control, and if they aren't in control, trying to get at the reason so proper recommendations or adjustments can be made. 

We are in the business to not just save lives, but help improve the quality of the life our members, and ourselves, live. Assessing control status through three questions allows our physician's and asthma care managers help our asthma patients achieve more GREEN days and breathe a little easier.