Key to successful asthma management: Education
Patients learn how to recognize their triggers
Education is the focus of Blue Care Network of Michigan’s asthma management program for adults and children — and it’s paid off.
Preliminary analysis of 2001 data shows a decrease in hospitalization, an increase in appropriate medication management, and a decrease in the number of days members with asthma miss from work or school.
The insurer’s asthma management team provides education for adults with asthma, children with asthma and their parents, teachers and school nurses, and physicians.
"Asthma is one chronic disease that patients can manage very well if they are educated," says Pam Reinert, MSM, director of quality management for Blue Care Network of Michigan, based in Southfield.
People with asthma need to know how to take their medication properly, to identify what triggers an asthma attack, and to eliminate the triggers, Reinert adds.
The majority of members in the asthma management program receive population-based educational materials three times a year and have access to the Blue Cross Blue Shield Health Line, a 24-hour-a-day, seven-days-a-week nurse-call system.
"They know that if they need help, they should contact us. Otherwise, we don’t identify them as having special needs," Reinert says.
Members who are assessed to be at high risk for asthma attacks and those who are hospitalized or visit the emergency room are referred for more intensive contact by the insurer’s care management department.
Among the educational materials is the Asthma Action Plan, which members and their physicians can individualize to help patients keep track of when their asthma is under good control.
The plan provides the members’ primary care physicians with educational material on asthma treatments, information from the patient data registry, and regular reminders of the need for preventive treatment.
"Overall, we’ve seen a decrease in hospitalization for asthma. Last year, we had an increase in the number of people going to the emergency room to be treated for asthma. That’s not a good sign. We’re working to find out where the problem is and correct it," Reinert says.
She credits the increase in appropriate medication management to the insurer’s physician education program and to giving data on medication use to physicians.
Respondents to a survey of the adult population report a decrease in the amount of time they missed from work because of asthma in 2001 compared to 2000. "Members responded that they felt they knew better how to manage asthma than a year ago," she added.
Parents said they missed fewer workdays in 2001 because of their child’s asthma, and that the children had missed fewer school days.
"Those are great signs for the value of the program," she says.
Helping people with asthma recognize what triggers asthma attacks is one key to asthma management, Reinert says. There may be environmental factors, like exposure to second-hand smoke, pet dander, or dust. If they are children, they may have an attack right before a sports event or after heavy exertion. Stress may trigger an event. So may a change in weather, or being in a congested, crowded area, she adds.
The disease management team has begun collaborating with school systems and teachers to increase awareness of asthma. "We want to educate them on how asthma affects the child and his well-being and how they can help the child in the school situation," she says.
The insurer sends educational materials to all of the schools in its area and schedules inservice seminars at schools where there is a high population of members to educate the school staff about asthma.
"We go to the schools; we don’t confine ourselves to teachers of students covered by the Blue Care Network. We want any child with asthma to benefit from the program," Reinert says.
Staff talk to the teachers and show them what the asthma treatment equipment looks like and how the child should use it.
"One of the things we found out in our studies is that a lot of emergency room visits were from children being sent directly from school to the emergency room. We hope this program will help cut down on that," Reinert says.
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