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Common issues and practical actions with tools you can print to document and improve outcomes for your pediatric asthma clients and their families.

RECOMMENDATIONS FOR PHARMACISTS

  • You are a VERY important partner in asthma management for your clients
  • You can make a difference for your clients! The Sydney, Australia study "The Pharmacy Asthma Action Plan Project" (B. Swain et al) showed that a pharmacist intervention of reviewing device technique, medication expectations and a written action plan revealed a 63% positive response from patients in achieving or working towards the goals they had set for themselves with their asthma

Remember to:

  • Confirm/clarify diagnosis and prescribed medications
  • Explain action of medications
  • Demonstrate device technique and confirm patient technique (have client demonstrate to you)
  • Supply/draft Asthma Management Plan (link to plan on CANA website)
  • Fax medication history to family physician if you are concerned
  • Refer rural patients to HEALTH LINK to connect them to available asthma resources in their community 1-888-408 LINK (5465)

We suggest you:

  • Update your CRE credentials with Pharmacists' Association of Alberta (RxA) and INFORM ALBERTA. Make sure they know WHERE you practice!
  • Add a link to your pharmacy computer(s) to the Alberta Chronic Asthma Pathway (link)
  • For dosing information, see Alberta Acute Asthma Pathway (link)
  • See Alberta CPGs for Asthma at Toward Optimized Practice (link)
  • Utilize free tools. Visit www.ucalgary.ca/icancontrolasthma. See Health Providers section

STATUS CONCERN ACTION RESOURCES

TAKE THE OPPORTUNITY!

  • Young teen/self management
  • Upcoming intense physical activity
  • Provide AB Asthma Action Plan?
  • Provide appropriate device illustration sheet (available in 13 languages)?

CAREFUL

  • High doses of inhaled corticosteroids
  • Inappropriate device for age
  • More than 1 type of asthma device
  • Notify physician. Ask for change to appropriate device
 

CAUTION

  • Questions from family about need to continue preventer medication
  • Explain medication action?
  • Book appointment with pharmacist for education?
  • Refer for asthma education?
  • Notify physician if warranted?
  • See example Pharmacy Action Plan for Pediatric Asthma (Chinook example?/link)
  • Calgary: Use pharmacy referral for asthma education form at bottom of Health Providers page www.ucalgary.ca/icancontrolasthma
  • Edmonton: Shauna - what is the eCare info on this? Can we use it here?
  • Rural: Call Health Link
  • Fax medication history to physician

CAUTION

  • No Action Plan
  • Provide blank Asthma Action Plan to take to physician?
  • Refer for asthma education?

CAUTION

Short-acting beta agonist overuse (SABA) aka "Rescue/Reliever"
  • Relief lasts <3 hours
  • same day repeated use
  • refill more than 1x in 6 months
  • prescription extensions
  • Explain medication action?
  • Ensure proper technique and appropriate device?
  • Refer for asthma education?
  • Refer patient to emergency/urgent care if relief lasts <3 hours and/or patient admits to repeated same day use
  • Notify physician if patient is refilling SABA too frequently and/or does not use ICS/Controller as prescribed?
  • See example Pharmacy Action Plan for Pediatric Asthma (Chinook example?/link)
    www.ucalgary.ca/icancontrolasthma
  • Calgary: Use pharmacy referral for asthma education form at bottom of Health Providers page www.ucalgary.ca/icancontrolasthma
  • Edmonton: Shauna - what is the eCare info on this? Can we use it here?
  • Rural: Call Health Link
  • Fax medication history to physician

URGENT

Severe symptoms:
  • Breathing very fast
  • Panting or gasping for breath
  • Trouble speaking
  • Blue-grey lips or fingernails
Serious symptoms in young children/babies:
  • In-drawing - skin at base of neck, between ribs or below breastbone pulls in with each breath
  • No energy to play or even move around
  • Babies may be refusing to eat or drink
  • Call 911?
  • Send to nearest Emergency Department or Urgent CareRefer for asthma education?
  • Get a copy of "A Child Is Having An Asthma Attack." Since asthma is often linked to allergies, also see "What To Do In An Anaphylaxis Emergency"
    www.canahome.org/resources.html
 
 
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