Table 4 The alphabet
A | Asthma (Dutch: astma). Is it asthma, what type of asthma and is it only asthma? |
Items: | |
Has asthma been diagnosed according to the guidelines Explanation what is difficult-to-manage asthma Identification of patients with difficult-to-manage asthma What is the difference between difficult-to-manage asthma and severe asthma Role of different phenotypes of asthma Which other tests should/could be performed other than symptoms and spirometry, to diagnose asthma The role of comorbidity in asthma How to assess different phenotypes of asthma in a patient Differential diagnosis of asthma and which potential concurrent diagnoses require further investigation Further insight into the potential consequences of a diagnosis of severe asthma (such as the use of biologicals, revalidation-therapy, high-altitude treatment..) | |
B | Bronchial triggers (Blootstelling). Allergens and irritants causing symptoms |
Items: | |
Effect of smoking on asthma Insight into allergens Insight into nonspecific irritants Role of passive smoking Insight into occupational irritants Insight into hobby-related irritants Knowledge about the relation between symptoms and work | |
C | Asthma control (Controle). How to assess and monitor asthma control |
Items: | |
Determining current control: ACQ, exacerbation rate, persistent obstruction Content of monitoring in the individual patient Role of the ACQ Frequency of monitoring for the individual patient Clear guidelines for referrals between primary and hospital care Identification of patients suitable for pulmonary rehabilitation | |
D | Device (Device). Which device and how to use it? |
Items: | |
Role of inhalation instruction Assessment of adherence Role of device type: match between patient and device | |
E | Exacerbations (Exacerbaties). How to prevent, detect and treat exacerbations |
Items: | |
An asthma action plan for every difficult-to-manage asthma patient Identification of patients with an increased risk Definition of a (severe) asthma exacerbation Recognition of causing agents of exacerbations | |
F | Pharmacotherapy (Farmacotherapie). Which types of medication for which individual patient |
Items: | |
Denominate central role-inhaled corticosteroids Patient perceptions on benefits and necessity of medication Pharmacotherapy for specific subgroups: does comorbidity determine medication choices Common side-effects different types of medication | |
G | General behaviour (Gedrag). How does behaviour and lifestyle influence asthma and how to modify it |
Items: | |
Attention for physical activity Role of weight Recognition of stress-inducing factors | |
H | Help (Hulp). Strengthen the knowledge and determine who can aid a patient in disease management |
Items: | |
Identification of obstacles for adherence (social, financial, societal) Education on asthma Insight into the patients' personal environment | |
I | Individualised care plan (Individueel Zorg Plan). How to create and use a self-management plan for each individual patient |
Items: | |
Self-management for all people with (difficult-to-manage) asthma Necessity of an individual care plan for all patients with (difficult-to-manage) asthma Recognition and acceptance of personal limitations Determining personal goals of treatment. Identification of patients suited to different types of self-management: paper, online, real-life How to make patients aware of asthma worsening events/behaviour Estimation of desire and potential for behavioural changes |
