Basic Tools for Ambulatory Management of Asthma and COPD

Improvement Objective: Decrease asthma/COPD morbidity and mortality in affected adults and children through improved quality of asthma/COPD case-management (ambulatory)

Key Interventions:

  • Bronchodilator for active symptoms
  • Inhaled steroid for all persistent asthma (tailored to severity) and moderate-severe disease (FEV1 < 60%)
  • LABA and/or anti-cholinergic (FEV1 < 60% or moderate-severe COPD) Identification & control triggers & risk factors;
  • Exacerbation management and refferal to hospital: oral or IV steroid, nebulized bronchodilator, oxygen if needed
    Patient self-management support

Printable and downloadable versions

  • Evidence-based Change Package

 

 

Routine indicators for monitoring quality of care

Process

  • AA-P1: % charts in which  chronic medications list is up to date
  • AA-P2: % of patients seen for asthma/COPD for which asthma/COPD classification status documented
  • AA-P3: % of patients seen for asthma for which asthma control status documented (patient-reported)
  • AA-P4: % of patients seen for asthma/COPD for which treatment is adjusted to control/severity status
  • AA-P5: % of patients with persistent asthma classification treated with controller medication
  • AA-P6: % of patients with moderate to severe COPD treated with LABA, anti-cholinergic or ICS
  • AA-P7: Average # with non-EB medications prescribed for asthma/COPD management at last visit
  • AA-P8: % of patients with asthma or COPD risk-factors (BMI, Diet), assessed & modification plan developed
  • AA-P9: % of patients with asthma or COPD triggers (pets, viral infections, dust, smoking environment), assessed & modification plan developed
  • AA-P10: % of patients with asthma or COPD in whom tobacco status assessed and specific counseling (treatment) provided (abstinence or tobacco cessation)


OUTCOME

  • AA-O1: % patients seen for asthma who report good asthma control
  • AA-O2: % patients with asthma a requiring treatment for asthma exacerbation in last six months