Launching its first retail medical clinics in 2000, MinuteClinic, a division of CVS Caremark Corporation, has about 600 locations across 25 U.S. states and the District of Columbia. Its health care model responds to consumer demand, making access to quality medical treatment simpler and more affordable for many. With a 95 percent customer satisfaction rating, the retail health care provider could further benefit its patients by utilizing the asthma disease management resources and tools from Lungtropolis.com.
Asthma in the U.S.
Asthma disease management costs Americans about $56 billion per year, according to the Centers for Disease Control and Prevention (CDC). Between the years 2002 and 2007, the medical expenses associated with treatment of the disease grew by $1.5 billion. Consequently, the growing cost of asthma means there are numerous opportunities for financial incentives for Employee Assistance Programs, Healthcare Insurers and Health Systems to offer a wellness program that can help improve the outcome of asthma patients, minimize health-related issues and save time.
Asthma is a growing health epidemic and the leading cause of hospitalizations in children under the age of 15. With this condition, patients must play an intensive and critical role in their own disease management. Thus, education and support from health care providers are vitally important to improving the health outcome of asthma patients. Asthma patients and those with other chronic illnesses are attractive customers to retail pharmacies looking to attract new, loyal customers. By offering in-store health services, CVS was able to target this market.
The Benefit of ORCAS
MinuteClinics have served as a vital resource for those who dont have health insurance, and several employers now offer MinuteClinic access in their health plans. Consequently, there is significant opportunity to improve the outcomes of patients with asthma and reduce its related costs by offering asthma disease management services, knowledge, tools and skills. By explaining asthma to children and their parents with the use of the asthma games developed by Lungtropolis (an ORCAS program), MinuteClinic can stand out from its competitors in a way thats attractive, lucrative and low cost.
Lungtropolis.com offers a variety of free online resources to patients particularly children and their parents. With the variety of online asthma disease management resources available, there is still significant room to improve upon the innovation, quality, reach and efficacy of such programs. A partnership between ORCAS and MinuteClinic could help get the ball rolling.
Asthma education for kids is a way to empower asthmatic children living with the chronic disease. The more your child knows about this condition, the better he or she can manage symptoms. By creating an Asthma Action Plan with your childs health care provider, you can help your child avoid asthma triggers, recognize the warning signs of a possible asthma episode and take control.
Peak Flow Meter
Asthma information for kids should include knowledge of how to use a peak flow meter, a device that tells how well a child is able to push air out of his or her lungs. The meter provides a tangible way for your child to monitor his or her condition and detect warning signs of breathing difficulties.
The peak flow meter has a green, yellow and red tab that a health care provider slides to a specific spot to indicate an asthma zone. After blowing into the peak flow meter, an arrow will point to a number that corresponds to a color on the tab. With your child, compare the color on the tab to the asthma zone on the Asthma Action Plan, and follow the instructions.
Asthma Action Plan
In addition to including your childs basic information (name, important phone numbers and so on), an Asthma Action Plan lists your childs asthma triggers, medications, severity of asthma and peak flow meter personal best. The plan is divided into three zones, which correspond to the colored tab on the peak flow meter: green, yellow and red. If your child doesnt have the peak flow meter handy, the action plan describes symptoms your child may feel within each zone.
The Green Zone is when there are no asthma-related symptoms. The Yellow Zone is for when your child begins to experience some difficulties breathing. When your child is in the Red Zone, he or she is experiencing a breathing emergency and needs to go to the emergency room. Each zone provides a set of instructions to help control an asthma episode, including a list of medications and their dosage.
Work with your childs health care provider when creating an Asthma Action Plan. If the provider doesnt have an action plan form, you can download one here.
Once your child is old enough to read, help her to remember to refer to the Asthma Action Plan each time she uses her peak flow meter. You can also help your child by providing caregivers and other adults with helpful asthma information and a copy of the Asthma Action Plan.
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Good asthma condition management is about more than making sure your child takes prescribed asthma medicines. Its about more than doing your best in spite of his or her symptoms. Its about understanding the asthma symptoms children commonly experience and preventing them; knowing your childs asthma triggers; and helping your child follow the treatment plan even when he or she feels well.
Good Control Asthma Checklist
When it comes to asthma symptoms, children should not experience wheezing, disturbed sleep, coughing or other associated symptoms more than three days out of the month. If this is happening, you need to revise your childs asthma condition management strategy with a health care provider. Even though asthma is a chronic condition, good management is not about your child living with asthma symptoms. Its about living symptom-free.
Asthma is a chronic condition that cant be cured, and its the third-leading cause of hospitalizations in children under the age of 15. Health care providers need to be able to provide asthma education tools and resources at the time of diagnosis so parents and children can learn how to manage this disease. With good asthma management, patients will have fewer or no symptoms and be as active as they want to be. Tools like Lungtropolis.com can help you inform your young patients and their parents.
According to the National Heart, Lung and Blood Institute, access to professional and patient asthma education tools; increased knowledge of asthma management strategies; regular patient monitoring; and continuing asthma education can help physicians:
Because patient appointments are brief, the following questions can help you determine the key educational messages to provide to your patients and their parents:
If the patient is young, you may need to direct some or all of these questions at a parent. In addition, you should also learn what the patient (and his or her parent) hopes to accomplish during the visit; treatment expectations; and any questions or concerns they may have. Use the answers to provide educational messages regarding:
Often, a patients asthma management is only as good as the resources and tools provided by her physician. By ensuring a good partnership with your patients, you can empower them to take control, be healthy and improve their quality of life.
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Hospitals, health care companies and states are implementing asthma disease management programs to help asthma sufferers improve their quality of life and help everyone involved lower the cost of care. When patients learn self-care and asthma control techniques, they are less likely to miss school or work, be hospitalized or go to the emergency room as a result of the disease. According to a report provided by Delaware Health and Social Services, the implementation of programs relating to asthma disease management can also help reduce the severity of asthma.
Asthma Disease Management Trends
Hospital management programs. Clinical pharmacists, like the ones at Cedar-Sinai Health Associates, provide asthma patients with asthma control skills by helping them identify triggers (so they can avoid or reduce their exposure to them) and use asthma-related devices correctly, including spacers, peak flow meters and inhalers. Asthma disease management programs vary by health care facility.
Wellness programs from health care companies. Avivia Health , a program for group members of Kaiser Permanente plans, provides a wellness program for those who suffer from chronic conditions, including asthma. The Level One program involves a Health Risk Assessment, asthma control education and access to tools that teach self-care skills. Level Two has the same offerings as Level One and includes unlimited calls to a health coach. The Level Three program offers general awareness activities, calls to and from health coaches and web-based campaigns.
State-based programs. States like Washington and Delaware incorporate asthma disease management plans into their Medicaid programs. Such programs help provide asthma control education to populations that are most at risk for asthma-related complications, such as those with lower income levels. These programs help patients gain access to asthma education, identify and avoid asthma triggers, manage symptoms and monitor their disease. The purpose of such programs is to help improve the health and quality of life of residents and keep health care costs low for all parties. State-based programs continually measure the outcomes of such programs, including their costs, against the demands of society to measure their effectiveness and value.
With the rise of preventative care and wellness programs, patients have increased access to educational resources and tools that can help make living with asthma less of a challenge. A simple phone call to your health care provider, local hospital, county health department or community center can help you find resources near you.
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Asthma control often begins with knowing asthma triggers. The most common type of asthma, according to WebMD, is allergic asthma, which is when an allergen causes the immune system to overreact and affect the lungs and airways. ScienceDaily reports that asthma is the most common chronic illness in children worldwide; the number of people who suffer from the disease has doubled within the last 10 years.
Many parents of asthmatic children practice asthma control by knowing the allergy triggers that lead to distressed breathing and reducing exposure to them. One more tool that may help reduce allergy/asthma symptoms in the future is a promising new vaccine that can help combat one of the most common allergens asthma patients face. Although it will be years before the vaccine becomes available in the United States, its a development worth keeping an eye on.
Common Allergy and Asthma Triggers
Allergy/asthma symptoms can include wheezing, coughing, rapid breathing, shortness of breath and tightening of the chest. Triggers that can cause this reaction include:
Dander from animals
Dust mite and cockroach feces
Smoke from tobacco products or a fireplace
Chemicals such as those found in perfumes, paint, pesticides, adhesives, etc.
Allergic Asthma Vaccine
The research scientists at Inserm and CNRS (Institut du thorax, CNRS/Inserm/University of Nantes) found that their new vaccine, when injected intramuscularly into mice, reduced the bodys sensitivity to the allergen and the consequential inflammatory response. Findings regarding the vaccine were published in the June issue of Human Gene Therapy.
Currently, to help patients control allergy/asthma symptoms, doctors administer corticoids, desensitization treatments through immunotherapy and leukotriene modifiers. The new vaccine, however, uses the DNA of the allergen found on dust mites, Dermatophagoides farinae 1 (Derf1), instead of traditional allergen extracts. The initial research has only been conducted on mice, but the next step in this asthma control treatment is human testing.
The vaccine is still a long ways off from full development and FDA approval. Although it offers hope for asthma sufferers, in the meantime its still important for patients to continue proactively managing their disease. Currently, the best way to control asthma symptoms is to seek the help of a physician, learn to identify and avoid triggers, and follow your doctors instructions for taking your asthma medications
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Prevention and disease management programs are some of the best ways to help keep health care costs low. According to the American Lung Association , about 7.1 million children under the age of 18 were affected by asthma in 2009. The health care cost of the chronic disease is about $50.1 billion annually. Furthermore, asthma is the leading cause of school absences and the third-leading cause of hospitalizations in children under age 15. Health insurance providers are finding that asthma education tools go a long way toward reducing the prevalence of asthma-related emergency room visits, asthma episodes and hospitalizations.
Health Plans for Asthma Condition Management
The U.S. Environmental Protection Agency encourages health insurance providers with established asthma condition management programs to implement home visit programs. Along with medical treatment and the management of environmental triggers in the home, the implementation of a home visit program can help teach skills about asthma condition management, thus reducing health care costs for health plans and enrollees.
The following are the steps the EPA suggests to help health plan providers get started with the development of a home visit program:
1. Identify the benefits of a home visit program as part of a traditional asthma condition management plan. By going into a home and helping identify asthma risk factors and triggers like pests, dust mites, secondhand smoke, pets and molds, enrollees will experience medical benefits as well as financial and economic benefits. Health plans will also experience financial and economic benefits, plus theyll gain competitive advantages.
2. Get leadership buy-in. Talk to the executives within your health plan about the benefits of asthma education and home visit programs; estimate a budget that includes time and money; and design a pilot program.
3. Create an implementation team. Consider including the companys asthma case manager, network physicians, analyst, the medical director and the utilization management director, among others.
4. Develop the home visit programs structure. Define the goals of the program, its components, the number of home visits and the individuals who will conduct the home visits.
5. Decide which enrollees will be part of the program. A plan can include all of the individuals with asthma, or only those with the most severe cases.
6. Develop outreach strategies. Consider who will contact enrollees and how; the features of a good outreach program (such as multi-lingual staff and incentives); and how health care providers will learn about the program.
7. Determine what outcomes and outputs will be measured (and how). Common outcomes measured include asthma-related hospitalizations; missed days of work or school; and the percentage of enrollees using an asthma action plan.
8. Develop tools and forms, and train staff. Forms can include checklists, asthma action plan templates, intake forms and tracking forms.
9. Form partnerships with local asthma organizations. Doing so can provide the company with enrollee referral relationships as well as provide vital collaborative opportunities.
10. Begin the program, and track results. Tracking should measure the efficacy of the program, evaluate areas of improvement and identify areas that could be expanded.
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The American Lung Association reports that asthma is the top reason for missed school days. In 2008, an estimated 14.4 million children in the United States experienced a school absence because of their asthma symptoms, according to the Centers for Disease Control. One of the best ways teachers, parents and caregivers can help children control their allergy/asthma symptom is to become familiar with asthma education resources and put the tips into practice.
Teachers and School Personnel
School personnel can help address asthma management by providing asthma resources and education; tailoring school health services to incorporate the needs of asthmatics; encouraging kids with asthma to be active when theyre able; and providing a healthy school environment. While its important for teachers to have knowledge about asthma, the health office should also be prepared for asthma emergencies. Furthermore, teaching kids about asthma self-management, like through the Open Airways for Schools Program , can help them maintain better control over their allergy/asthma symptoms so they can focus on learning.
Parents and Caregivers
Knowledge is one of the best tools for parents and caregivers of asthmatic children. Asthma resources provided by schools and physicians can help you learn about a childs environmental triggers, recognize the signs of distress and know what to do when theres an asthma emergency. Teaching children about their asthma and how to control their symptoms can also go a long way toward reducing school absences. Teaching tools can include the online learning game Lungtropolis as well as make-believe asthma scenarios. Because children arent always at home, its important to provide your community with asthma education resources to help family, friends, babysitters and neighbors know what to do if your child experiences related complications.
Control of asthma symptoms must be an ongoing effort, not just an issue thats addressed when a child is in distress. By using the resources recommended by the American Lung Association , you can make a positive impact on school absenteeism rates.
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ORCAS Research Scientist Susan Schroeder, MPH, MCHES, PMP will present some of the latest techniques in asthma self-management at the upcoming The Forum 12 event Oct. 18, 2012, in Atlanta, Ga. Schroeders presentation, Development and Evaluation of an Online Asthma Self-Management Game for Children, will highlight the asthma game ORCAS offers on Lungtropolis.com.
Lungtropolis uses health behavior-change theory in an interactive, web-based game to help children ages 5-10 learn to control their asthma. The ORCAS asthma game was created in collaboration with the American Lung Association to give children and their parents a resource that provides valuable information and guidance about asthma management.
Ms. Schroeders session will discuss how the games design helps achieve desired outcomes, as well as the following:
The rationale for the creation of an online game to promote asthma self-management in children.
The combination of theoretically based messaging and instructional design with game mechanics to enhance the learning experience.
An analysis of a randomized controlled trial that was conducted with a national sample of 311 parent-child pairs, which helps prove the efficacy of such an intervention.
With the prevalence of chronic conditions on the rise, innovative thinking is a must in light of the constraints placed on health care spending and the emphasis on accountability and performance created by policymakers. Ms. Schroeders presentation at The Forum 12 will demonstrate how Lungtropolis offers a creative solution to a complex problem in population health management.
Asthma education is one of the best tools parents have to manage a childs asthma symptoms and promote a healthy school environment. The Healthy Schools Network website provides you with asthma education tools for working with your school and community to create greener, asthma-friendly environments. It also discusses how you and like-minded parents can promote a healthy school environment for all children. On the site, you can also find tip sheets and activities; review helpful questions to ask schools; and learn how to spot environmental problems on campus.
Healthy Schools Network provides parents with a handful of activities they can implement to increase asthma awareness in schools and communities. Such activities include:
Another helpful resource is the American Lung Associations Asthma-Friendly Schools Initiative , which offers a planning toolkit based on asthma management activities that have been successfully used in schools throughout the country.
The next National Healthy Schools Day is Tuesday, April 30, 2013. This day focuses on the positive steps your childs school has taken toward promoting a healthy learning environment and teaches others about the importance of a clean, green school. National Healthy Schools Day is the perfect time for you to promote asthma education to school and district officials, teachers, students, faculty and community organizations.
One of the most helpful topics for parents with asthmatic children to teach others about relates to asthma triggers often found in schools. Triggers can include:
Learn more about asthma triggers a child may encounter in a school from the Lungtropolis website.
Asthma education tools are an important resource for parents when managing a childs asthma. Furthermore, awareness can help make asthma symptom management simpler for parents and children. Its never too late to encourage your childs school to be asthma-conscious.
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The prevention of asthma symptoms is critical to patients and their families. The Centers for Disease Control and Prevention (CDC), National Asthma Education and Prevention Program (NAEPP), U.S. Department of Health and Human Services (DHHS) and other agencies have unveiled new developments in the treatment and management of asthma. These agencies have found that the control and prevention of asthma flare-ups is as simple as knowing and recognizing and managing asthma signs and symptoms.
Health agencies have found that activities relating to asthma control must extend beyond the doctors office and into public health outreach efforts. According to a May 2012 CDC Asthma Fact Sheet, children across the U.S. who have asthma missed more than 10 million days of school in 2008 because of the disease. The medical costs associated with the asthma are estimated at $50 billion per year.
In light of this information, the CDC has extended its outreach efforts into communities and schools to help create healthy living and learning environments through its National Asthma Control Program (NACP). The NAEPP has focused its outreach efforts on promoting the creation of Asthma Action Plans, particularly in vulnerable communities. These plans help patients and their families keep track of asthma signs and symptoms and medications, as well as create a plan for avoiding triggers and effectively dealing with asthma emergencies. Furthermore, the Affordable Care Act will help provide health care coverage to asthmatic children who would otherwise be denied coverage because of their condition.
The efforts of targeted outreach programs that focus on the prevention of asthma symptoms have already resulted in successes. For example, the NACP has helped reduce the amount of asthma-related emergency room visits by up to 39 percent; encouraged the creation of laws that require asthma education in schools; helped reduce health care burdens; and provided asthma-related services in areas that never had them in the past.
While there is no cure for asthma, the prevention of asthma symptoms
is possible. The latest developments and outreach efforts not only help patients, but also support doctors who wish to provide more resources to asthma
sufferers and their families.
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The school year is often the time parents need the most help with asthma management for their children. When children are in an environment parents cant control, there is an increased risk of exposure to respiratory infections and asthma triggers. Respiratory infections are a common cause of asthma flare-ups in young children. The following tips will help you prepare your child to practice effective asthma condition management during the new school year.
Encourage hand washing. Hand washing is one of the best ways your child can avoid catching a cold or flu. Teach your child about the importance of covering his or her own coughs and sneezes, as well as simple-to-remember hand washing techniques. For example, a thorough hand washing means scrubbing your hands long enough to hum the Yankee Doodle tune in your head.
Get the proper vaccines. One of the best ways to help with asthma and avoid respiratory infections is to get a flu vaccine at the beginning of the school year.
Role play. Just as you do fire drills in your home, you can also conduct asthma drills. This will help your child know what to do if there is an asthma emergency. Furthermore, teach your child to talk about his or her condition to peers and other adults. For example, pretend that a certain situation poses possible asthma triggers, and practice with your child what he or she should say and do.
Talk to your childs teacher and friends parents. The adults in your childs life want him or her to be healthy and safe. The American Lung Association recommends that you talk to the childs teacher, nurse and PE teacher about asthma condition management. Also make sure that the parents of your childs friends are aware of asthma triggers and have your contact information.
For more information about helping your child get ready for the new school year, check out these Lungtropolis tips
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The first line of defense in diagnosing and treating asthma is a patients health care provider. Nevertheless, asthma condition management remains an under-recognized need. The National Asthma Education and Prevention Program (NAEPP) created Guidelines for the Diagnosis and Management of Asthma (EPR-3), which gives physicians a new look at the control and prevention of asthma attacks and symptoms.
In the updated guidelines, the NAEPP outlines six clinical practice recommendations to aid with asthma condition management. These include:
1. The use of inhaled corticosteroids (ICS). According to the NAEPP, inhaled corticosteroids are one of the most effective and preferred tools for the long-term control of persistent asthma in children and adults. Its vital that physicians communicate the effectiveness and importance of ICSs to patients and their care givers.
2. Written asthma action plans. Written plans are integral to the self-management and prevention of asthma symptoms. While physicians can give patients and families asthma management instructions orally, the instructions can be easily forgotten. An asthma action plan is a clearly written set of instructions and an informational guide that helps patients self-manage their condition, identify asthma triggers, recognize worsening asthma symptoms and have a plan in place for asthma attacks.
3. The assessment of asthma severity. When health care providers first meet with a patient, the NAEPP recommends they conduct a severity assessment to measure the current level of impairment the asthma symptoms cause. This assessment helps determine future risk and create an initial treatment plan.
4. The assessment and monitoring of asthma control. When a patient returns for follow-up appointments, the health care provider should assess the patients level of asthma control as well as future risks. Regular monitoring and assessments allow a physician to determine what therapy option needs to be maintained or adjusted.
5. Periodic physician visits. Asthma symptoms vary greatly, and an asthma attack can occur with seemingly little warning. Therefore, its important for physicians to schedule follow-up visits (and for patients to keep their appointments). These appointments assist with the monitoring and assessment of a patients asthma condition management.
6. Controlling environmental exposure to asthma triggers. When a health care provider knows a patients asthma triggers, like allergens and irritants, he or she can create a plan to help the patient
reduce the risk of exposure. This technique aids in the prevention of asthma symptoms and can make a patients self-care efforts more successful.
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According to the Centers for Disease Control and Prevention (CDC), asthma is the most prevalent chronic disorder in children. In 2009, the CDC found that asthma affected 7.1 million children and youths under the age of 18, and more than half of that population suffered an asthma attack or episode during the same year. Furthermore, asthma was the top third reason for hospitalization in children under the age of 15 in 2006 and was the top reason for school absenteeism in 2009. Asthma control is a big deal, both for children who suffer from the disease and for their parents. When a childs asthma symptoms arent managed, his or her quality of life is greatly reduced. By participating in asthma disease management programs together, parents and children can increase their odds of success.
Children with asthma sometimes need motivation and support when it comes to controlling their symptoms. By creating a written promise to practice asthma control together, you can help reassure your child that he or she does not have to deal with the disease alone. You can make your own written agreement or download and print our pre-made Asthma Agreement, which includes the following:
Asthma control is more successful when you and your child work together. Download the Lungtropolis.com Asthma Agreement today to get started!
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The Centers for Disease Control and Prevention (CDC) estimates that in 2009, 24.6 million American adults had asthma. During the same year, the disease affected 7.1 million children under the age of 18. As for the financial impact, the CDC estimates that the direct cost of treating asthma in children and adults is about $50.1 billion, while indirect costs amount to $5.9 billion, for a total of $56 billion annually.
The occurrence of asthma, a lifelong disease, is on the rise. For example, from 2001 to 2009, the number of people diagnosed with asthma grew by 4.3 million. As experts gather asthma information, they find that medical expenses related to the treatment of the disease are also increasing. Such expenses rose to $50.1 billion in 2007, a $1.5 billion increase in the span of five years. According to the CDC, 11 percent of asthma patients who had health insurance couldnt afford their prescription medications. Among the uninsured, 40 percent couldnt afford their asthma medications.
In addition to economic costs, asthma has educational and professional costs . In 2008, 59 percent of children with asthma missed school because of an asthma attack, and 33 percent of adults with asthma missed work. On average, children with asthma missed four days of school, while adults missed five days of work. Additionally, asthma is the third leading cause of hospitalization among children who are 15 and younger.
Asthma in children has an impact on the lives of both young people and their families. Fortunately, access to asthma information and education can help improve the quality of life and reduce medical expenses. The CDC reports that fewer than 50 percent of asthma patients learned how to avoid triggers in 2008. By creating an asthma action plan with a physician and following the recommendations listed, asthma patients can manage their symptoms with more success.
At Lungtropolis.com, an ORCAS website, we offer asthma information and educational resources
to help parents learn how to empower children to manage their asthma. In 2012, ORCAS completed a randomized control trial funded by the National Heart Lung & Blood Institute to test the efficacy of Lungtropolis® with 311 parent-child pairs. Forty-five days after use of the web program, children in the treatment group showed significant gains in knowledge about asthma management, and parents felt more confident about managing their childrens asthma.
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