Crisis asmatica

National Asthma Education and Prevention Program

Guidelines Implementation Panel Report for: Expert Panel Report 3—Guidelines for the Diagnosis and Management of Asthma

Partners Putting Guidelines Into Action

National Asthma Education and Prevention Program

Guidelines Implementation Panel Report for: Expert Panel Report 3—Guidelines for the Diagnosis and Management of AsthmaPartners Putting Guidelines Into Action

NIH Publication No. 09-6147 December 2008

Table of Contents

Acknowledgments Preface Introduction
Background: How Can We Do Better? Objectives of the GIP Report Approach to Evidence Review A Call to Action

1 3 5
5 5 6 6

Overview of the GIP Report
Convening the Panel Developing the GIP Implementation Plan Framework for Developing GIPRecommendations and Strategies Core Themes Guiding Principles of Patient-Centered Care Priority Messages Health Disparities: A Fundamental Issue Framework for Mobilizing Asthma Partners into Action Crosscutting Strategies Overarching Implementation Approaches Partnering for Success Evaluating the GIP Implementation Plan

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7 7 7 7 10 10 10 10 10 11 11 13

The GIP Implementation Plan: Recommendationsand Strategies
Use Inhaled Corticosteroids Communication Systems Integration Patient/Provider Support Use a Written Asthma Action Plan Communication Systems Integration Patient/Provider Support Assess Asthma Severity Communication Systems Integration Patient/Provider Support Assess and Monitor Asthma Control Communication Systems Integration Patient/Provider Support Schedule Periodic VisitsCommunication Systems Integration Patient/Provider Support

15
18 18 19 19 20 20 22 22 23 23 24 25 25 25 27 27 29 29 30 31

Control Environmental Exposures Communication Systems Integration Patient/Provider Support

32 32 34 35

Appendices
A. Levels of Evidence for EPR-3 Recommendations B. Patient-Centered Care Model C. Health Disparities D. Abbreviations

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38 39 42 44

List of FiguresFigure 1. Summary of GIP Priority Messages and the Underlying EPR-3 Recommendations* Figure 2. Framework for Developing GIP Recommendations and Strategies By Message Figure 3. Mobilizing Asthma Partners Into Action — Where Does My Organization Fit? Figure 4. Overview: GIP Report Development Process Figure 5. Integration of GIP Messages and Strategies for Dynamic Engagement of Stakeholders and aComprehensive Implementation Approach Figure 6. Menu of Implementation Activities — What Can My Organization Do? 8 9 12 14 16 17

Acknowledgments

NAEPP Guidelines Implementation Panel The NAEPP is grateful to all the Guidelines Implementation Panel members for meeting the challenge of developing this report with tremendous dedication and zeal, and to Dr. Kevin Weiss for his outstandingleadership. A special thanks to the writing team for their extra effort to prepare this report. Kevin B. Weiss, M.D., M.P.H., M.S., Chair * American Board of Medical Specialties Evanston, Illinois David B. Callahan M.D. * Centers for Disease Control and Prevention Atlanta, Georgia Michelle M. Cloutier, M.D. * Connecticut Children’s Medical Center Hartford, Connecticut Denise Dougherty, Ph.D. Agency forHealth Care Policy and Research Rockville, Maryland Kurtis S. Elward, M.D., M.P.H., F.A.A.F.P. * Family Medicine of Albemarle Charlottesville, Virginia David Greenberg Centers for Medicare and Medicaid Services Baltimore, Maryland Carol Jones, R.N., A.E.-C * Certified Asthma Educator Consultant Tucson, Arizona Thomas J. Kallstrom, F.A.A.R.C., R.R.T., A.E.-C American Association for RespiratoryCare Irving, Texas

Jim Krieger, M.D., M.P.H. + University of Washington Harborview Medical Center Seattle, Washington Marielena Lara, M.D., M.P.H. * Research and Development Corporation Santa Monica, California Padmanbhan “Dan” Mukundan, M.D. Access Community Health Network Chicago, Illinois Judith C. Taylor-Fishwick, M.Sc., AE-C National Respiratory Training Center Norfolk, Virginia Gwendolyn...