CE/CME

Identifying and Treating Children with Asthma

Welcome to the training on Identifying and Treating Children with Asthma provided by the Texas Health and Human Services Commission (HHSC) and the Texas Department of State Health Services (DSHS).

Credit Hours: 1.25 CE

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To enroll in this course, please log in or create a new account if you are not already registered.

Overview
Appendix/Resources

Goal

The goal of this module is to equip Texas Health Steps providers and other health care professionals to identify asthma, apply a stepwise treatment approach when managing asthma patients in a primary care setting and make appropriate referrals for specialty care.

Target Audience

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 and help educate patients and families on managing asthma.

Please note this module expires on 11/14/2026.

This module was released on 11/14/2023.

References

Featured

Allergy & Asthma Network. (n.d.). Can you smoke if you have asthma?
American Lung Association. (2023). Asthma Causes & Risk Factors.
American Lung Association. State of the Air. (2023). Most Polluted Cities.
Asthma and Allergy Foundation of America. (2017). Tobacco Smoke.
Beasley, R., Harrison, T; Peterson, S., et al. (2022). JAMA Network Open. Evaluation of Budesonide-Formoterol for Maintenance and Reliever Therapy Among Patients With Poorly Controlled Asthma. 5(3):e220615.
Centers for Disease Control and Prevention. (2023). Asthma.
Centers for Disease Control and Prevention. (2022). Health Problems Caused by Secondhand Smoke.
Centers for Disease Control and Prevention. (2023). Most Recent National Asthma Data.
Rohlfs Rivera, D. L., & Abreo, A. (2021). Emergency Department Visit Count: A Practical Tool to Predict Asthma Hospitalization in Children. Pediatrics December 2021; 148 (Supplement 3): S50. 10.1542/peds.2021-053843VVV
healthline. (2023). Understanding the Connection Between Secondhand Smoke and Asthma.
Islam, T., Braymiller, J., Eckel, S. P., et al. (2022). Secondhand nicotine vaping at home and respiratory symptoms in young adults. Thorax 2022;77:663-668.
Li, X., Zhang, Y., Zhang, R., Chen, F., Shao, L., Zhang, L. American Journal of Preventive Medicine. (2022). Association Between E-Cigarettes and Asthma in Adolescents: A Systematic Review and Meta-Analysis. 62(6):953−960.
Lizzo, J. M., & Cortes, S. (2023). Pediatric Asthma (book, updates).
Mayo Clinic. (2021). Allergies and asthma: They often occur together.
McQuaid, E. L., & Landier, W. (2018). Cultural Issues in Medication Adherence: Disparities and Directions. Journal of General Internal Medicine, 6(2), 200-206.
Pinyochotiwong, C., Chirakalwasan, N., Collop, N. (2021). Nocturnal asthma. Asian Pacific Journal of Allergy and Immunology. 39:78-88.
Shim, J.Y. (2023). Wheezing in infants and preschoolers: phenotypes and treatment options. Clinical and Experimental Pediatrics. 66(1); 2023.
Texas Department of State Health Services. (2023). Prevalence Of Current Asthma Among Adults And Children, By Demographic Characteristics, Risk Factors / Comorbid Conditions, And Place of Residence, Texas, 2021.
Texas Department of State Health Services. (2022). 2021-2022 Administered Unassigned Asthma Medication in Schools Report.
Texas Medical Board. (n.d.). Respiratory Care Practitioner Application Process Overview.
UpToDate. (2023). Obesity and asthma. (English | Chinese)
U.S. Environmental Protection Agency. (2023). NAAQS (National Ambient Air Quality Standards) Table.
U.S. Environmental Protection Agency. (2022). Integrated Pest Management (IPM) Principles.
Wong, Chu-Hai, Morton, Robert W. (2021). Monitoring adherence in children with asthma. Paediatrics and Child Health. 31(7): 284-289.
World Health Organization. (2023). Asthma.
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.

Definition

The medical definitions in this module were obtained or adapted from the American Academy of Allergy, Asthma & Immunology, Mayo Clinic, Tom Wade, MD, U.S. National Library of Medicine and WebMD.

Accreditation Statements

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 1.25 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 1.25 contact hour(s) of Continuing Nursing 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 1.25 total entry-level Category I contact education contact hours.

Social Workers

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 1.25 contact hour(s) of Continuing Social Work Education.

Certificate of Attendance

The Texas Department of State Health Services, Continuing Education Service has designated 1.25 hour(s) for attendance.

Disclosures

General Disclosure

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).

Browser Requirements

Texas Health Steps courses are best viewed using a current browser. If you are using an out-of-date browser or a version of Internet Explorer less than 11, lesson progress and interactive features may not function properly.

Resources for Health-Care Providers

Al-Shamrani, A., Bagais, K., Alenazi, A., Alqwaiee, M., & Al-Harbi, A.S. (2019). International Journal of Pediatric & Adolescent Medicine. Wheezing in children: Approaches to diagnosis and management. 6(2): 68–73.
Allergy & Asthma Network. (n.d.). What is SMART Therapy for Asthma?
American Academy of Allergy, Asthma & Immunology. (2022). Immunomodulator Allergy Medications.
American Academy of Allergy, Asthma & Immunology. (n.d.). Non-Allergic Asthma.
Centers for Disease Control and Prevention. (2023). Asthma Action Plans. Available in English, Spanish and 11 other languages.
Cleveland Clinic. (2021). Leukotriene Modifiers.
Global Initiative for Asthma. (2023). Global Strategy for Asthma Management and Prevention. (2023 update).
Got Transition. (2023). Six Core Elements of Health Care Transition.
healthline. (2023). What Is the Asthma Predictive Index?
Mayo Clinic. (2022). Asthma.
Mayo Clinic. (2022). Asthma: Steps in testing and diagnosis.
Medscape. (2023). Pediatric Asthma Treatment & Management.
National Heart, Lung, and Blood Institute. (2020). 2020 Focused Updates to the Asthma Management Guidelines: A Report from the National Asthma Education and Prevention Program Coordinating Committee Expert Panel Working Group.
National Heart, Lung, and Blood Institute. (2022). Tests for Lung Disease.
National Library of Medicine, MedlinePlus. (2022). How to use a nebulizer.
Norfolk and Waveney Clinical Commissioning Group. (2021). Asthma Primary Care Guideline.
Paediatric Child Health. (2021). Childhood asthma and school. 26(1): e4–e5.
Texas Commission on Environmental Quality. (2023). Today’s Texas Air Quality Forecast.
Texas Medicaid & Healthcare Partnership. (2023). Texas Medicaid Provider Procedures Manual.
Texas Health and Human Services. Vendor Drug Program. (2023). Preferred Drugs.
Texas Health and Human Services. Vendor Drug Program. (n.d.). Emergency Override.
Texas Health and Human Services. Vendor Drug Program. (n.d.). Formulary Search.
Texas Medicaid & Healthcare Partnership (TMHP). (2023). Preferred Drugs.
Texas Medicaid & Healthcare Partnership. (TMHP). (n.d.). Provider Search.
UpToDate. (2023). Obesity and asthma.
U.S. Environmental Protection Agency and PARTNERS. AirNow. (2023) Get air quality where you live.
U.S. Environmental Protection Agency. (2023). Nonattainment Areas for Criteria Pollutants (Green Book).

Resources for Patients and Families

American Lung Association. (n.d.). About Kickin’ Asthma.
American Lung Association. (2022). Assess and Monitor Your Asthma Control.
American Lung Association. (2023). Asthma Basics.
American Lung Association. (2023). Breathe Well, Live Well.
American Lung Association. (2023). Open Airways for Schools.
American Lung Association. (2023). Reduce Asthma Triggers.
American Lung Association. (2022). Teens and Asthma.
American Lung Association. (2023). Valved Holding Chambers and Spacers.
Asthma and Allergy Foundation of America. (2022). Mold Allergy.
Asthma and Allergy Foundation of America. (2022). Pet Allergy.
Asthma.net. (2022). Asthma Inhalers and Dental Health.
Cleveland Clinic. (2023). Childhood Asthma.
Got Transition. (2023).
Healthwise, Inc. (n.d.). Asthma Diary Template.
healthychildren.org. (2022). Asthma & Respiratory Viruses: How to Keep Kids Healthy.
Mayo Clinic. (2021). Dust mite allergy.
Mayo Clinic. (2023). Levalbuterol (Inhalation Route).
StatPearls. (2022). Albuterol.
StatPearls. (2023). Ipratropium.
StatPearls. (2023). Theophylline.
Texas Department of State Health Services. (n.d.). CSHCN Transition.
Texas Health and Human Services Commission. Your Texas Benefits. (2023). Learn how Your Texas Benefits can help you.
Texas Health and Human Services Commission. (n.d.). Children with Special Health Care Needs Program.
U.S. Environmental Protection Agency. (2023). Asthma Triggers: Gain Control.
verywell health. (2022). Can Your Period Worsen Your Asthma?

How-To Videos

American Lung Association (2023). Dust Mites.
American Lung Association. (2023). How to Clean a Nebulizer.
American Lung Association. (2023). How to Use a Metered-Dose Inhaler with a Valved Holding Chamber (Spacer).
Boston Children’s Hospital. (n.d.) How to clean an inhaler and spacer.
Mayo Clinic. (2023). How to use a dry powder tube inhaler.
Johns Hopkins Medicine. (2021). Steps to Using an Inhaler with a Spacer and Mask.