Known or Suspected Asthma Clinical Pathway — Primary Care

Asthma Education and Discharge Instructions

Only about 20% of health challenges caused by an asthma diagnosis are solved by medication. Improving factors (provider factors, patient factors) and health literacy affect outcomes as well. It is important to provide teaching and reinforce education at every patient interaction.

In general, providers will introduce and order discharge teaching, then nurses or asthma navigators will enforce the required learning prior to discharge.

General	Ensure all asthma patients receive annual influenza vaccine Instruct patient/family to bring medications to next visit Ensure caregiver has forms necessary for daycare, school and work Use Care Assistant Tool to guide teaching Patient Education
New Diagnosis Background	Asthma as a chronic disease Discuss natural history of asthma Discuss seasonal variation in asthma
Medication	New Diagnosis Identify best medication, explain function, side effects, best times to take medications Known Diagnosis Discuss concerns and barriers to adherence Review medication use and have family “teach back” Discuss the difference between controllers and rescues Name each medication and its classification How to use devices When possible, administer medications at point of care
Asthma Action Plan	Discuss three zones and when to use flare plan
Symptoms and Triggers	Review Early symptoms of asthma flare How to avoid triggers
Modifiable Factors	Discuss trigger and avoidance techniques Avoid tobacco, vaping, cigarillos Use culturally appropriate communication techniques Discuss barriers to care, adherence strategies Consider skin testing or ImmunoCAP for allergens
When to Call the Office	Yellow zone symptoms fail to improve after 2 days
When to go to the ED	Red zone symptoms are present

If you have questions about any of the clinical pathways or about the process of creating a clinical pathway, please contact us.

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The clinical pathways are based upon publicly available medical evidence and/or a consensus of medical practitioners at The Children’s Hospital of Philadelphia (“CHOP”) and are current at the time of publication. These clinical pathways are intended to be a guide for practitioners and may need to be adapted for each specific patient based on the practitioner’s professional judgment, consideration of any unique circumstances, the needs of each patient and their family, and/or the availability of various resources at the health care institution where the patient is located.

Accordingly, these clinical pathways are not intended to constitute medical advice or treatment, or to create a doctor-patient relationship between/among The Children’s Hospital of Philadelphia (“CHOP”), its physicians and the individual patients in question. CHOP does not represent or warrant that the clinical pathways are in every respect accurate or complete, or that one or more of them apply to a particular patient or medical condition. CHOP is not responsible for any errors or omissions in the clinical pathways, or for any outcomes a patient might experience where a clinician consulted one or more such pathways in connection with providing care for that patient.

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Known or Suspected Asthma Clinical Pathway — Primary Care

Asthma Education and Discharge Instructions

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Asthma, Known or New Diagnosis Clinical Pathway — New Diagnosis Education and Discharge Instructions — Primary Care

Known or Suspected Asthma Clinical Pathway — Primary Care

Asthma Education and Discharge Instructions