Asthma, Known or New Diagnosis Clinical Pathway — Adherence/Medication Delivery Tips — Primary Care

Known or Suspected Asthma Clinical Pathway — Primary Care

Adherence/Medication Delivery Tips

Prescription Component Review Steps
Choosing Correct Medication
  • Consider medication and device delivery based on age and asthma control
  • Review medication properties and side effects
  • When possible give patients choices
  • Demonstrate proper technique in using medication device through teach-back and the MDI checklist
  • Use the lowest dose possible for the best asthma control
  • Assess satisfaction with treatment plan. Ask questions in non-judgmental manner
    • What concerns/fears do you have about using this medication?
    • How can I make you feel more comfortable with using this medication?
    • When would be the best time for your child to take the medication?
MDI or DPI
Chamber and Medication
  • Identify which medications actually taken
  • Check
    • Dose counter
    • Expiration date
    • Correct device
    • Proper technique every visit
MDI + Spacer
Technique Checklist
  1. Remove the cap from both inhaler and spacer
  2. Inspect the spacer for foreign objects
  3. Attach the inhaler to the spacer
  4. Shake the inhaler (and spacer)
  5. Keep the head and neck in a neutral position and breathe out
  6. Place the spacer in mouth
  7. Press down on inhaler to release medication
  8. Breathe in slowly (3 to 5 sec)
  9. Hold breath for 10 secs
  10. Wait one minute and repeat puffs as directed
Teach-back Method to
Promote Adherence
  • Ask child to explain or demonstrate what they have learned:
    • “Now that I’ve shown you how the MDI with spacer works, can you show me how you will use it?”
    • “Can you tell me what you will do when your child has a flare?”