New Care Process Model for Asthma

kids with asthma inhalers

An Intermountain system-wide team of Pulmonary, Allergy, and Children’s Health experts created a new Asthma Care Process Model (CPM) to improve the standardization of evidence-based asthma care.

The CPM contains three age-based streamlined workflows which focus on the appropriate use of Single Maintenance and Reliever Therapy (SMART) and placement of patients within the stepwise treatment plan recommended by the National Heart, Lung, and Blood Institute.

The new Asthma CPM reflects the guidance for asthma treatment from the 2020 National Heart, Lung, and Blood Institute (NHLBI) and 2022 Global Initiative for Asthma (GINA). The SMART guidelines include: 
  • Preference for the use of SMART for patients ≥4 years of age with moderate persistent asthma (treatment steps 3 and 4 NHLBI). 
  • SMART is defined as an inhaled corticosteroid (ICS) in combination with formoterol. Not appropriate for SMART are ICS and salmeterol or vilanterol combination inhalers.
Asthma Care Process Model

Other tools to help initiate and manage stepwise treatment:

  • PowerPlans: iCentra PowerPlans for ambulatory care have been developed for stepwise treatment guidance for ages 0-4, 5-11, and 12- adult. They reflect the recommended stepwise medication combinations and dosages as currently recommended by NHLBI. Search: PUL ASTHMA
  • Autotext: use ambasthma to facilitate documentation of PowerPlan usage
  • Asthma Control Tables: 2011 Guidance from NHBLI regarding up and down movement within treatment steps

For more information:

 

 Contributors  


Heidi Thompson, PhD
Clinical Education, Medical Writer/Consultant
Intermountain Health, Canyons Region


Robert Silge, MD
Associate Medical Director-Allergy & Immunology
Intermountain Health, Canyons Region             


Marni Chandler, RN, MBA
Clinical Program System Executive Clinical Director
Intermountain Health, Canyons Region


References:

2020 Focused Updates to the Asthma Management Guidelines, National Heart, Lung, and Blood Institute (NHLBI)

2022 Global Strategy for Asthma Management and Prevention Global Initiative for Asthma (GINA)