4 Ways Retail Clinicians Can Optimize Asthma Management

With as many as 1 in 12 US residents having asthma, retail clinicians are primed to help this patient population manage their chronic condition.

Patients are increasingly visiting physician assistants (PAs) and nurse practitioners (NPs) at retail clinics for asthma treatment, especially because of the anticipatedphysician shortagein the near future.

Almost 65% of adults with asthma have persistent asthma, while 35% have intermittent asthma, according to the US Centers for Disease Control and Prevention (CDC).

Kristen Marjama, DNP, FNP-BC, education and training manager with Walmart Care Clinics, shared the following 4 tips for optimizing asthma management.

1. Find ways to overcome barriers to asthma management.

Dr. Marjama identified a few challenges in helping patients manage their asthma, including time. Clinicians just do not have adequate time to educate their patients in many cases. They may also have issues finding privacy consultation space and administrative support.

She suggested that retail clinicians can overcome these barriers by focusing on strategizing in each individual clinic. Clinicians can then better focus on which patients are at risk, make time for education, work collaboratively, and provide feedback on what works and what doesn’t.

2. Dispel asthma treatment misconceptions and correct errors.

Patients with asthma may need some more information about the differences between short- and long-acting medications.

Dr. Marjama pointed out that some patients may say their long-acting bronchodilators do not work as well, but retail clinicians can tell these patients that they might not necessarily feel them working. The long-acting treatment should control their asthma levels so that they do not have to use their short-acting bronchodilators as much for acute symptoms.

“Our technical features are getting better, but if a patient doesn’t know how to use them correctly, they’re not going to get the medication into their lungs,” Dr. Marjama said.

Three common errors that patients make when using inhalers are that they do not exhale before inhaling the medication, they do not hold their breath for 5 to 10 seconds to allow the medication to settle into their lungs, and they do not rinse their mouth after inhalation.

Retail clinicians can remind patients about these techniques so that they get the right amount of medication in their lungs to be effective.

3. Check in with patients about asthma symptoms.

Clinicians need to know when and which asthma medication to prescribe to their patients.

For those with intermittent asthma, a short-acting beta-agonist used from time to time will be their best bet.

“The problem is, many times, they are using it way more than they should, and that goes unrecognized by health care providers,” Dr. Marjama said.

To correct this, retail clinicians should make sure to ask about nighttime and daytime symptoms, coughing, and wheezing, just in case the patient needs to take the next step up in therapy and start a controller medication. This way, patients will reduce their risk of scarring or permanent loss of lung function.

4. Reinforce the need for a written asthma action plan.

Dr. Marjama maintained that one of the most important things clinicians need to consider when treating patients with asthma is to check that they have a written asthma action plan.

Studies show that fewer than 25% of patients who need an asthma action plan don’t have one, according to Dr. Marjama.

Health care providers may not be giving plans out, patients may not be sure how to use the plan, or they may just be resistant to it. However, clinicians can help by asking them if they have a written plan and are using it.

“Patients don’t think it’s even important from a health care provider’s perspective,” Dr. Marjama said. “The more we ask questions about it, the more they know ‘I need my action plan.’ Action plans help them know what to do, how to manage their asthma, and what to do when their asthma worsens.”