What is Asthma Asthma Diagnosis and Symptoms SAMBA

What is Asthma? Asthma Diagnosis and Symptoms SAMBA Care Coach Training

These slides were compiled from materials by: • Dr. Jonathan Arend, MD • Assistant Medical Director for Clinical Operations and Clinical Quality at Mount Sinai Hospital Internal Medicine Associates • Gabriela A. Espinosa, LMSW • Pediatric Asthma Social Worker at Mount Sinai Hospital • Adam M. Karp • Clinical Research Coordinator at the Icahn School of Medicine at Mount Sinai • Priscilla Toral, LCSW • Pediatric Asthma Social Worker at Mount Sinai Hospital • Melissa Saperstein, LMSW • Social Worker at Mount Sinai Hospital SAMBA Care Coach Training – What is Asthma?

What Is Asthma? Asthma is a chronic disease of the lungs. It causes the airways to become narrowed and inflamed. Asthma does not go away but it can be controlled. SAMBA Care Coach Training – What is Asthma?

Who Has Asthma? SAMBA Care Coach Training – What is Asthma?

Who has Asthma? • 8% of all adults have asthma (7% of those 65 and older) • Asthma is the 4 th leading cause of absenteeism (accounts for 14. 2 million lost work days per year) • Each year, 2 million ER visits and 15 million physician office visits were due to asthma • In 2009, over 3, 000 deaths were due to uncontrolled asthma SAMBA Care Coach Training – What is Asthma?

Asthma Physiology • When we breathe in air flows into our mouth or nose, through our trachea (which runs through the throat). • The trachea divides into two major branches called bronchi (bronchus for singular). • The bronchi carry air into each lung. As they travel into the lung, they divide into smaller airways (bronchioles). • At the ends of the smallest bronchioles are tiny air sacs (alveoli). Alveoli contain tiny blood vessels which allow the oxygen from the air to be absorbed into the blood stream. • Oxygenated blood is then pumped throughout the body to any area that needs it. SAMBA Care Coach Training – What is Asthma?

Asthma Physiology Tracheobronchial Tree Trachea Bronchiole Lung Alveoli Bronchus SAMBA Care Coach Training – What is Asthma?

Asthma Physiology • Asthma is a condition where the airways in the lungs (bronchi and bronchioles) narrow. • During an asthma attack, airways narrow making it difficult for the patient to breathe. SAMBA Care Coach Training – What is Asthma? Mayo Clinic Staff. Diseases and Conditions: Asthma. Retrieved from http: //www. mayoclinic. org/diseases-conditions/asthma/basics/definition/con-20026992 Medline Plus: The Patient Education Institute, Inc. (2012). Asthma. Retrieved from http: //www. nlm. nih. gov/medlineplus/tutorials/asthma/id 059105. pdf [Normal and Asthmatic Airways] Retrieved 2 July, 2014, from http: //www. nlm. nih. gov/medlineplus/magazine/issues/fall 11/images/asthma-airways_lg. jpg

Asthma Physiology SAMBA Care Coach Training – What is Asthma?

Causes of Airway Obstruction in Asthma • Airway Inflammation (swelling) • Bronchoconstriction (tightening of airways in the lungs) • Airway hyper-responsiveness • Mucus Plug Formation (mucus buildup in the airways) • Chronic airway remodeling (restructuring of airways, making them narrower) SAMBA Care Coach Training – What is Asthma? Mayo Clinic Staff. Diseases and Conditions: Asthma. Retrieved from http: //www. mayoclinic. org/diseases-conditions/asthma/basics/definition/con-20026992 Medline Plus: The Patient Education Institute, Inc. (2012). Asthma. Retrieved from http: //www. nlm. nih. gov/medlineplus/tutorials/asthma/id 059105. pdf http: //www. theasthmacenter. org/index. php/disease_information/asthma/

Asthma Symptoms • When the airways in the lungs narrow, people with asthma can experience a variety of symptoms: • • • Shortness of breath Chest tightness or pain Wheezing Coughing Trouble sleeping IMPORTANT: Every asthmatic will have different symptoms SAMBA Care Coach Training – What is Asthma?

Asthma Symptoms • Symptoms range from minor to severe; some people only face asthma symptoms upon exposure to certain triggers • Acute asthma attacks, if severe, can lead to hospitalizations and may be life-threatening • Symptoms can be controlled with proper tracking and management • Medications can be used to reduce airway inflammation and allow easier breathing SAMBA Care Coach Training – What is Asthma? Mayo Clinic Staff. Diseases and Conditions: Asthma. Retrieved from http: //www. mayoclinic. org/diseases-conditions/asthma/basics/definition/con-20026992 Medline Plus: The Patient Education Institute, Inc. (2012). Asthma. Retrieved from http: //www. nlm. nih. gov/medlineplus/tutorials/asthma/id 059105. pdf

Complications • Symptoms can disturb regular activities, including sleep and work • Absences from work or school may occur • Emergency room visits and hospital admissions • In severe cases, the airway shape may change permanently SAMBA Care Coach Training – What is Asthma? Mayo Clinic Staff. Diseases and Conditions: Asthma. Retrieved from http: //www. mayoclinic. org/diseasesconditions/asthma/basics/definition/con-20026992

Asthma is chronic… It cannot be cured, but it can be controlled. SAMBA Care Coach Training – What is Asthma?

Asthma Control • Asthma is chronic. It cannot be cured, but it can be controlled. • Once you are diagnosed with Asthma, you will always have it. The doctor cannot cure your asthma. • The goal of a SAMBA care coach is to help patients control their asthma. • Patients with controlled asthma can experience few to no symptoms. SAMBA Care Coach Training – What is Asthma?

How to Control Asthma ASTHMA CONTROL Reduce those allergens/irritants Know your triggers Take medications as prescribed Recognize your Symptoms SAMBA Care Coach Training – What is Asthma?

Common Barriers to Asthma Control Social barriers Medication adherence issues Difficulty accessing care Environmental Triggers SAMBA Care Coach Training – What is Asthma?

Social Barriers • • Insurance Issues Transportation Issues Mental Health (Depression/Anxiety) Cultural Perceptions Abuse/Domestic Violence Housing Issues Language Barriers SAMBA Care Coach Training – What is Asthma?

Medication Adherence Issues • Cultural Perceptions • Memory Impairments (forgetting to take medication) • Health Literacy (e. g. difficulty differentiating between controller and rescue medicines) • Multi-morbidity Prioritizations (taking multiple medications for different conditions at one time, asthma not seen as a priority) • Illness Beliefs (e. g. Patients concerned about side effects) SAMBA Care Coach Training – What is Asthma?

Difficulty Accessing Care • Language Barriers • Health Literacy Barriers • Transportation Issues • Rely on transportation that often falls through • Insurance Issues SAMBA Care Coach Training – What is Asthma?

Environmental Triggers • • • Dust Smoking Rodents Cockroaches Cold Air Food Allergies Pets Pollen Strong Emotions Etc. SAMBA Care Coach Training – What is Asthma?

Issues with managing exposure to triggers • Patients may not be able to control environmental triggers around them • E. g. - cigarette smoke coming from next door apartment • Cannot always remove triggers in home • E. g. – may not be able to afford to remove carpet, unwilling to give up pets, family members who smoke SAMBA Care Coach Training – What is Asthma?

Role of the Care Coach • Help patients: • understand that asthma is a chronic disease that can not be cured but can be controlled. • understand asthma physiology, symptoms & complications. • achieve asthma control by overcoming common barriers such as: social barriers, medication adherence issues, difficulty accessing care & environmental triggers. SAMBA Care Coach Training – What is Asthma?