Asthma Care Reminder
The National Institute of Health (NIH) National Asthma Education and Prevention Program recommends that patients with persistent asthma should be treated with an inhaled corticosteroid. According to the NIH National Heart, Lung, and Blood Institute guidelines, chronic inhaled corticosteroid use is safe in adults and children, and can be the most effective and preferred first-line control therapy for asthma1. Inhaled corticosteroids improve asthma control more effectively than any other long-term control medications. An analysis of eight cohort and ecologic studies conducted strongly suggest that inhaled corticosteroids, when taken regularly, can decrease the number of hospitalizations for asthma by up to 80 percent2. Pharmacy claims often show that asthma patients rely on albuterol rescue inhalers as the primary treatment for their asthma. A patient refilling their albuterol rescue inhaler more than once a month may be an indication that their asthma is not being appropriately treated.
If your patients are not adherent to, or are resistant to taking their inhaled corticosteroid as directed, please discuss and address their concerns. Some reasons patients may not be taking inhaled corticosteroids are:
- Concerns about taking a steroid medication (inhaled corticosteroids have fewer and less severe systemic side effects than oral steroids),
- Lack of immediate relief that albuterol inhalers can provide
- Difficulty remembering twice daily dosing
- Improper inhaler technique (have your patient demonstrate their technique while in the office)
- In rare cases, thrush (prevented by rinsing mouth after use)
It is highly recommended that you work with your patient to create an asthma action plan. An asthma action plan can be a written, individualized worksheet showing your patient the steps to take in order to prevent their asthma symptoms worsening. Also, for patients with persistent asthma, assess their symptoms and determine if an inhaled corticosteroid is appropriate.
Blue Cross and Blue Shield of Montana uses the GuidedHealth® clinical rules platform to review claims data that it receives to help identify members who have had a claim for an asthma rescue inhaler but have not received an inhaled corticosteroid. The prescribing physicians of these identified members are sent informational letters on a quarterly basis to help increase awareness and promote patient safety.
BCBSMT is also committed to working with communities to help improve pediatric asthma care. Through a collaboration with the American Lung Association of the Upper Midwest (ALAUM), BCBSMT is supporting the Enhancing Care for Children with Asthma Project, a program that implements community-based interventions to improve the health outcomes of children with asthma. For more information about the Enhancing Care for Children with Asthma Project, visit the ALAUM at lung.org.
1.Global Strategy for Asthma Management and Prevention. Global Initiate for Asthma (GINA) 2012.
2.Suissa, Samy et al. Inhaled corticosteroids: Impact on asthma morbidity and mortality. J Allergy Clin Immunol. 2001. Jun;107(6):937-44.
GuidedHealth is a registered trademark of Prime Therapeutics LLC (Prime), a pharmacy benefit management company. BCBSMT contracts with Prime to provide pharmacy benefit management and other related services. BCBSMT, as well as several other Blue Cross and Blue Shield Plans, has an ownership interest in Prime. BCBSMT makes no endorsement, representations or warranties regarding GuidedHealth. If you have any questions about this product or services, you should contact Prime Therapeutics directly.
The information mentioned here is for informational purposes only and is not a substitute for the independent medical judgment of a physician. Physicians are instructed to exercise their own medical judgment. Pharmacy benefits and limits are subject to the terms set forth in the member’s certificate of coverage which may vary from the limits set forth above. The listing of any particular drug or classification of drugs is not a guarantee of benefits. Members should refer to their certificate of coverage for more details, including