Welcome to the training on Identifying and Treating Children with Asthma provided by Texas Health and Human Services (HHS) and the Texas Department of State Health Services (DSHS).
Equip Texas Health Steps providers and other health-care professionals to identify asthma, apply a stepwise treatment approach as part of managing asthma patients in a primary care setting, and make appropriate referrals for specialty care.
Texas Health Steps providers and other interested health-care professionals.
Specific Learning Objectives
After completing the activities of this module, you will be able to:
- Specify what is involved in diagnosing asthma.
- Assess risk factors for asthma and counsel patients and families about risk-reduction strategies.
- Differentiate between the categories of asthma medications and medication delivery systems.
- Apply a recommended stepwise approach as part of managing asthma patients in a primary care setting.
Please note this module expires on 2/1/2021.
This module was released on 2/1/2018.
Continuing Medical Education
The Texas Department of State Health Services, Continuing Education Service is accredited by the Texas Medical Association to provide continuing medical education for physicians.
The Texas Department of State Health Services, Continuing Education Service designates this enduring material for a maximum of 1.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Continuing Nursing Education
The Texas Department of State Health Services, Continuing Education Service is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation. The Texas Department of State Health Services, Continuing Education Service has awarded 1.00 contact hour(s) of Continuing Nursing Education.
The Texas Department of State Health Services, Continuing Education Service under sponsor number CS3065 has been approved by the Texas State Board of Social Worker Examiners to offer continuing education contact hours to social workers. The approved status of The Texas Department of State Health Services, Continuing Education Service expires annually on December 31. The Texas Department of State Health Services, Continuing Education Service has awarded 1.00 contact hour(s) of Continuing Social Work Education.
Certified Health Education Specialists
Sponsored by The Texas Department of State Health Services, Continuing Education Service, a designated provider of continuing education contact hours (CECH) in health education by the National Commission for Health Education Credentialing, Inc. This program is designated for Certified Health Education Specialists (CHES) and/or Master Certified Health Education Specialists (MCHES) to receive up to 1.00 total entry-level Category I contact education contact hours.
Certificate of Attendance
The Texas Department of State Health Services, Continuing Education Service has designated 1.00 hour(s) for attendance.
One of the requirements of continuing education is disclosure of the following information to the learner:
- Notice of requirements for successful completion of continuing education activity. To receive continuing education credit the learner must successfully complete the following activities:
- Create a Texas Health Steps account.
- Complete on-line registration process.
- Thoroughly read the content of the module.
- Complete the on-line examination.
- Complete the evaluation.
- Commercial Support.
The THSTEPS Web-based Continuing Education Series has received no commercial support.
- Disclosure of Relevant Financial Relationships.
The THSTEPS Continuing Education Planning Committee and the authors of these modules have no relevant financial relationships to disclose.
- Non-Endorsement Statement.
Accredited status does not imply endorsement of any commercial products or services by the Department of State Health Services, Continuing Education Service; Texas Medical Association; or American Nurse Credentialing Center.
- Off-Label Use.
Using a disclosure review process, the THSTEPS Continuing Education Planning Committee has examined documents and has concluded that the authors of these modules have not included content that discusses off-label use (use of products for a purpose other than that for which they were approved by the Food and Drug Administration).
The following are policies and definitions of terms related to continuing education disclosure:
The intent of disclosure is to allow Department of State Health Services (DSHS) Continuing Education Service the opportunity to resolve any potential conflicts of interest to assure balance, independence, objectivity and scientific rigor in all of its Continuing Education activities.
All faculty, planners, speakers and authors of Department of State Health Services (DSHS) Continuing Education Service sponsored activities are expected to disclose to the Department of State Health Services (DSHS) Continuing Education Service any relevant financial, relationships with any commercial or personal interest that produces health care goods or services concerned with the content of an educational presentation. Faculty, planners, speakers and authors must also disclose where there are any other potentially biasing relationships of a professional or personal nature.
Glossary of Terms
Conflict of Interest: Circumstances create a conflict of interest when an individual has an opportunity to affect Continuing Education content about products or services of a commercial interest with which she/he has a financial relationship or where there are any other potentially biasing relationships of a professional or personal nature.
Commercial Interest: Any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients.
Financial Relationships: Those relationships in which the individual benefits by receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, ownership interest (e.g., stocks, stock options or other ownership interest, excluding diversified mutual funds), or other financial benefit. Financial benefits are usually associated with roles such as employment, management position, independent contractor (including contracted research), consulting, teaching, membership on advisory committees or review panels, board membership, and other activities for which remuneration is received or expected. Relevant financial relationships would include those within the past 12 months of the person involved in the activity and a spouse or partner. Relevant financial relationships of your spouse or partner are those of which you are aware at the time of this disclosure.
Off Label: Using products for a purpose other that that for which it was approved by the Food and Drug Administration (FDA).
- Adelman, R. D., Tmanova, L. L., Delgado, D., Dion, S., & Lachs, M. S. (2014). Caregiver Burden: A Clinical Review. JAMA, The Journal of the American Medical Association, 311(10): 1052-1060. (Abstract).
- Akinbami, L. J., Simon, A. E., & Rossen, L. M. (2015). Changing Trends in Asthma Prevalence Among Children. Pediatrics, 137(1), 2015-2354.
- American Academy of Pediatrics. (2013). Medical Home Chapter Champions Program on Asthma (MHCCPA).
- American Institute for Preventive Medicine. (2003). Asthma Triggers Diary.
- American Lung Association. (2017). State of the Air City Rankings.
- Asthma and Allergy Foundation of America and the National Pharmaceutical Council. (2005). Ethnic disparities in the burden and treatment of asthma.
- Beuther, D. A., & Sutherland, E. R. (2007). Overweight, obesity, and incident asthma: A meta-analysis of prospective epidemiologic studies. American Journal of Respiratory and Critical Care Medicine, 175(7), 661–66. (Abstract).
- Beuther, D. A., Weiss, S. T., & Sutherland, E. R. (2006). Obesity and asthma. American Journal of Respiratory and Critical Care Medicine, 174(2), 112–19 (Abstract).
- Burke, H., Leonardi-Bee, J., Hashim, A., Pine-Abata, H., Chen, Y., Cook, D. G., . . . & McKeever, T.M. (2012). Prenatal and passive smoke exposure and incidence of asthma and wheeze: Systematic review and meta-analysis. Pediatrics, 129(4), 735–44.
- Castro-Rodriguez, J. A. (2010). The asthma predictive index: A very useful tool for predicting asthma in young children. The Journal of Allergy and Clinical Immunology, 126(2), 212–16.
- Centers for Disease Control and Prevention. (2017). National Center for Health Statistics: Asthma.
- Centers for Disease Control and Prevention. (2014). 2014 Child Asthma Data: Behavioral Risk Factor Surveillance System (BRFSS) Prevalence Tables.
- Centers for Disease Control and Prevention. (2013). Asthma and Schools.
- Chu, Y. T., Chen, W. Y., Wang, T. N., Tseng, H. I., Wu, J. R., & Ko, Y. C. (2009). Extreme BMI predicts higher asthma prevalence and is associated with lung function impairment in school-aged children. Pediatric Pulmonology, 44(5), 472–79. (Abstract).
- Eggo, R. M., Scott, J. G., Galvani, A. P., & Meyers, L. A. (2016). Respiratory virus transmission dynamics determine timing of asthma exacerbation peaks: Evidence from a population-level model. Proceedings of the National Academy of Sciences, 113(8), 2194-2199. (Abstract).
- El Helaly, N., Kamel, Y., Abd Elaziz, E., Elwan, A., & Nabih, M. (2009). Childhood obesity and asthma severity: Is there a link? Journal of Biological Sciences, 9(3), 259-263.
- Elers, J., & Backer, V. (2010). Management of asthmatic adolescents. Annals of Respiratory Medicine, 1(1), 61–68.
- Environmental Protection Agency. (2012). National Ambient Air Quality Standards (NAAQS).
- Ginde, A. A., Santillan, A. A., Clark, S., & Camargo, C. A., Jr. (2010). Body mass index and acute asthma severity among children presenting to the emergency department. Pediatric Allergy and Immunology, 21(3), 480-488. (Abstract).
- Global Initiative for Asthma. (2017). 2017 Pocket Guide for Asthma Management and Prevention.
- How to Control Dust Mites. (video). WaysandHow.com.
- Hanson, J. R., Lee, B. R., Williams, D. D., Murphy, H., Kennedy, K., DeLurgio, S. A., Sr., …Reddy, M. (2016). Developing a risk stratification model for predicting future health care use in asthmatic children. Annals of Allergy, Asthma & Immunology, 116(1), 26-30. (Abstract).
- Hupp, J. R., Williams, T. P., & Firriolo, F. J. (2006). Dental Clinical Advisor. Mosby, Inc. Pp 29-30.
- Jensen, M. E., Wood, L. G., & Gibson, P. G. (2012). Obesity and childhood asthma: Mechanisms and manifestations. Current Opinion in Allergy and Clinical Immunology, 12(2), 186-92. (Abstract).
- Jones, S. E., & Lani Wheeler, L. (2004). Asthma inhalers in schools: Rights of students with asthma to a free appropriate education. American Journal of Public Health, 94(7):1102–1108.
- Kochanek, K. D., Murphy, S. L., Xu, J. Q., & Tejada-Vera, B. (2016). Deaths: Final data for 2014. National vital statistics reports, 65(4).
- Lawserver.com. (2016). Texas Government Code 531.073 – Prior Authorization for Certain Prescription Drugs.
- Martinez, F. J. (2002). Development of wheezing disorders and asthma in preschool children. Pediatrics, 109, Supplement E1: 362-367.
- Mayo Clinic. (2016). Asthma Causes.
- Mayo Clinic. (2016). How to use a single-dose dry powder inhaler. (video).
- National Heart, Lung, and Blood Institute. (2012). Asthma Care Quick Reference.
- National Heart, Lung, and Blood Institute. (2012). Types of Lung Function Tests.
- National Heart, Lung, and Blood Institute. (2007). Guidelines chart for Usual Dosages for Long-Term Control Medications for Youths 12 and older.
- National Heart, Lung, and Blood Institute. (2007). National Asthma Education and Prevention Program Expert Panel Report 3: Guidelines for the diagnosis and management of asthma.
- Tai, A., Volkmer, R., & Burton, A. (2009). Association between asthma symptoms and obesity in preschool (4–5-year-old) children. Journal of Asthma, 46(4), 362-365. (Abstract).
- Texas A&M University, Corpus Christi. (n.d.). Pollution Prevention Partnership (P3).
- Texas Commission on Environmental Quality (TCEQ). (n.d.). Today’s Texas Air Quality Forecast.
- Texas Department of State Health Services. (2017). Texas Health Steps Periodicity Schedule.
- Texas Department of State Health Services. (2015). Asthma: The Child Asthma Action Plan and Family Communication. Video. (Click on link to Video Library).
- Texas Department of State Health Services. (2014). 2012 Adult Asthma Fact Sheet—Texas.
- Texas Department of State Health Services. (2014). 2012 Child Asthma Fact Sheet—Texas.
- Texas Department of Transportation, Environmental Affairs Division. (2016). Texas Air Quality Nonattainment or Attainment-Maintenance Areas and Counties – December 20, 2016 (Version 6).
- Texas Health and Human Services. (2017). Children’s Health Insurance Program (CHIP).
- Texas Health and Human Services. (2017). Texas Vendor Drug Program: Preferred Drug List.
- Texas Medicaid & Healthcare Partnership. (2017). Texas Medicaid Provider Procedures Manual (TMPPM).
- Texas Medicaid & Healthcare Partnership. (2016). Texas Medicaid Provider Procedures Manual: Durable Medical Equipment, Medical Supplies, and Nutritional Products Handbook (Vol. 2).
- Texas Medical Board. Respiratory Care Practitioners Licensing.
- U.S. Department of Justice. (2012). Individuals With Disabilities Education Act.
- U.S. Department of Justice. (2012). Title II of the Americans with Disabilities Act.
- U.S. Environmental Protection Agency. (n.d.). Asthma and Outdoor Air Pollution.
- U.S. Environmental Protection Agency. (n.d.) Green Book: Texas Nonattainment/Maintenance Status for Each County by Year for All Criteria Pollutants.
- Weinberger, M., & Abu-Hasan, M. (2007). Pseudo-asthma: When cough, wheezing, and dyspnea are not asthma. Pediatrics, 120(4), 855–64. (Abstract).
- Wu, A. C., Li, L., Fung, V., Kharbanda, E. O., Larkin, E. K., Butler, M. G., … Lieu, T. A. (2016). Mismatching among guidelines, providers, and parents on controller medication use in children with asthma. Journal of Allergy and Clinical Immunology: In Practice, 4(5), 910-916. (Abstract).
- Yin, S. Y., Gupta, R. S., Tomopoulos, S., Mendelsohn, A. L., Egan, M., van Schaick, L., … Dryer, B. P. (2016). A Low-Literacy Asthma Action Plan to Improve Provider Asthma Counseling: A Randomized Study. Pediatrics, 126(1), 1-11.
- Asthma and Allergy Foundation of America.
- Texas Department of State Health Services. (2014). Texas Asthma Control Program Educational Materials.
- U.S. Department of Health and Human Services, National Institutes of Health. (2003). Making a difference in the management of asthma: A guide for respiratory therapists. (NIH Publication No. 02-1964).
The medical definitions in this module were obtained or adapted from the American Academy of Allergy, Asthma & Immunology, Mayo Clinic, the U.S. National Library of Medicine, and WebMD.