CDC Asthma Guidelines: Path to Improved Education and Management in the U.S.

The Center for Disease Control reports that more than 24 million Americans have asthma, affecting 1 in 12 children and 1 in 14 adults. (Most Recent Asthma). "Asthma is a disease that is lifelong and causes wheezing, breathlessness, chest tightness, and coughing ("Vital Signs", 2011). Asthma has become an illness that many people consider 'normal' because once you have asthma, there is no way to cure it. Rather, there are hundreds of ways to control it and make it a part of your daily lifestyle. Researchers and professionals are unable to determine why the number of people diagnosed with asthma continues to increase year after year.

Those with asthma have become dependent on inhalers and medication to control and minimize the daily effects.

The cost of treating asthma was estimated to be $62.8 billion in 2009 by private insurance, Medicaid, Medicare, and other third-party sources (Jang, Gary Chan, Huang, & Sullivan). Asthma also costs the United States about $3,300 per person with asthma each year from 2002 to 2007 in medical expenses ("Vital Signs", 2011). Additionally, "medical expenses associated with asthma increased from $48.6 billion in 2002 to $50.1 billion in 2007, which resulted in about 2 in 5 (40%) uninsured people with asthma that were unable to afford their prescription medicines and about 1 in 9 (11%) insured people with asthma that were unable to afford their prescription medicines ("Vital Signs", 2011). Based on these statistics, it can be deduced that asthma is a growing issue that is affecting millions of people and millions of dollars.

Asthma Education

Without the proper resources and access to proper education, someone with asthma cannot get the appropriate treatment to better themselves. According to the Centers for Disease Control and Prevention, there is a need for better asthma education ("Vital Signs", 2011). People with asthma can prevent their attacks and reduce triggers if they are educated in these areas. While many may not know the exact triggers for their asthma, there are lists available of what typical triggers are, such as tobacco smoke, mold, outdoor air pollution and colds and flu ("Vital Signs", 2011). Asthma triggers exist in almost all environments, especially in one's home, so it is important to be able to understand what triggers are and how to reduce exposure to these triggers ("Asthma: Home-Based Multi-Trigger, Multicomponent Environmental Interventions Children and Adolescents with Asthma", 2018). Based on surveys completed by the Centers for Disease Control and Preventions, less than half of people living with asthma knew how to avoid triggers.

In previous years, numerous studies and researches have been conducted to determine that asthma self-management education is effective in that it improves the outcomes of chronic asthma (Sheffer, A. L., & Taggart, V. S, 1993). Having the opportunity to learn about the disease, and the necessary steps to take to reduce the effects would allow a person with asthma to live as normal of a life as possible. The key benefits of educating people who have asthma in the self-management skills of self-assessment, use of medications, and actions to prevent or control exacerbations, include a reduction in urgent care visits and hospitalizations, reduction of asthma-related health care costs, and improvement in health status (Gibson and Powell, 2003). Increasing the access and availability of education would truly increase the ability of those living with asthma to better take care of themselves and to control their asthma.

Evidence of Community-Based Approaches

One of the key implementations of community-based approaches for asthma control and prevention has been in schools for children. Most schools, if not all, have a nurse or some sort of health clinic and the employees in that setting have been well educated to treat children when they come in for whatever illness. Recent studies have shown that while there are self-management education programs set up in most schools, these studies have set a standard for what self-management education in schools can produce. While there are differences in practice, they have the common features of providing education as part of the school schedule, focusing on age-appropriate abilities of the participants, involving parents, and following children for one year or more (Evans, Clark, Levison, Levin, and Mellins, 2001).

Efforts in Place at Eastern Michigan University

Eastern Michigan University has a health services clinic that is available to students, staff, faculty and immediate dependents. Upon review of the website and services offered, there was no evidence of any efforts in place for asthma control or prevention. While the services offered do indicate that patients can come in with any concerns, there are no specific services listed for someone with asthma. However, "Eastern Michigan University has adopted a tobacco-free policy that supports a healthy learning, living and work environment for all members of the campus community ("Tobacco Free", 2018). In this sense, Eastern Michigan University has some efforts in place to assist with those suffering from asthma or any health-related issues that can be triggered by tobacco smoke.

Evidence-Based Recommendation

An evidence-based recommendation for Eastern Michigan University to address the health issue of asthma is to implement educational programs that are offered at the University Health Services clinic. For example, the clinic may offer brochures or informational packers for someone that comes in to be treated for asthma after an attack or even for the first time in their life. If there are programs in place to assist this person in educating them about the resources available to help prevent and reduce their asthma, then that person can take advantage of these resources and self-manage their asthma. Alternatively, clinicians can offer assistance to patients by discussing resources one on one with the patient. If someone has never had an asthma attack or episode before, they cannot determine what caused their attack and how to prevent it in the future.

The Centers for Disease Control and Preventive reported that in 2009, more than 9% of adults suffered asthma in the state of Michigan. A year prior, in 2008, less than half of people with asthma reported being taught how to avoid triggers (Centers for Disease Control and Prevention, 2017). With this data alone, it is evident that there is a lack of resources and education programs available to those suffering from asthma. If someone does not know the resources that are available to better themselves, then they cannot get better.

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