Respiratory therapists are the lung health experts, and as such, have a responsibility to share their knowledge with physicians, nurses, and other members of the healthcare team. Nowhere is that truer than with asthma. According to the CDC, asthma affects 1 in 12 adults and 1 in 10 children living in the U.S., and they all require ongoing care and management to minimize symptoms and live their best quality of life.
Offering advice on asthma treatment and management to your colleagues, however, requires you to be up-to-speed on the latest developments in asthma care.
Start with the EPR3
“While I do believe that RTs are the lung health experts, I believe it’s important to acknowledge that we are not all asthma experts,” said Samantha Davis, MSRC, RRT, RRT-NPS, AE-C.
As a member of the National Asthma Education Certification Board (NAECB), Davis stresses that therapists must have a thorough understanding of the physiologic changes that occur during an asthma exacerbation and a solid working knowledge of current medications, therapies, factors affecting patient compliance, and more.
“Each RT chooses an area of specialization because it’s impossible for us to know about — and stay up-to-date with — every specialty,” she said. “Quality asthma education is no different. In order for RTs to leverage their knowledge and expertise to educate others, they must be educated themselves.”
She believes a good starting point is the EPR3 Guidelines published by the National Heart, Lung and Blood Institute (NHLBI), but stresses RTs should realize these guidelines may not reflect the most recent developments in asthma care.
“The most recent EPR3 Guidelines were published in 2007; as such, some of the pharmacologic information is not current,” Davis said.
Be aware of the goals
Fellow NAECB Board member Clifton Dennis, BHS, RRT, AE-C, advises therapists to be aware of the overall goals of asthma treatment so that they can effectively communicate those goals to fellow clinicians.
“Long-term goals are to reduce impairment by reducing chronic symptoms through the use of medications and environmental changes,” Dennis said. That means selecting medications that meet the patient’s needs and circumstances, as well as reviewing medication use, technique, and adherence at every visit.
He urges therapists to stress the need to develop a written asthma action plan for patients too. These plans work best when the patient and family are involved in developing them.
“Have all members of the healthcare team reinforce the educational points,” Dennis said.
He also believes therapists should advise their colleagues to treat any comorbid conditions that may be exacerbating the patient’s asthma, and recommend ways to control exposures to allergens, irritants, and pollutants that make asthma worse.
Davis stresses the need to share the four components of the EPR 3 Guidelines — assessing and monitoring severity, patient education, environmental control, and medications — and also believes therapists need to get up to speed on the common myths and misconceptions regarding asthma treatment, such as patients with asthma and physical exercise.
“We simply can’t afford that list to be spread any further,” Davis said.
She recommends physicians enroll in the Physician Asthma Care Education (PACE) program offered by the NHLBI. The PACE program is available at no charge and patients of participating physicians show both an improvement in symptoms and lower hospitalization rates.
Dennis offers five main takeaways RTs can quickly and easily communicate to physicians, nurses, and others on the asthma patient’s care team:
- Determine severity with each visit and treat according to current severity.
- Review asthma action plan and update with each visit.
- Use the “steps” to classify asthma severity and initiate treatment.
- Order medications that the patient can readily obtain, to include LABA/ICS therapy.
- Identify and address obstacles to medication adherence.
RTs have a lot to offer
When it comes to asthma, Davis believes RTs have a lot to offer their colleagues on the multidisciplinary team — not to mention the patients and families who struggle with asthma every day.
“RTs have a specialized knowledge and skill set that makes them well-positioned to be the go-to asthma experts,” she said. “Once the RT is familiar with the EPR3 Guidelines, current pharmacologic options, and recent literature, then knowledge-sharing can take place in a meaningful and beneficial way.”
One of the best ways for RTs to get up to speed on asthma is to take the AARC’s Asthma Educator Certification Preparation Course. The course covers asthma diagnosis, treatment, follow up, and more, and will also help attendees prepare for the NAECB exam leading to the Asthma Educator-Certified credential. Attendees who pass a post-test earn 10.5 CRCEs as well.
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