Helping patients attain and maintain asthma control: reviewing the role of the nurse practitioner

Abstract

Nurse practitioners (NPs) have a unique opportunity as frontline caregivers and patient educators to recognize, assess, and effectively treat the widespread problem of uncontrolled asthma. This review provides a perspective on the role of the NP in implementing the revised National Asthma Education and Prevention Program (NAEPP) Guidelines put forth by the National Heart, Lung, and Blood Institute, thereby helping patients achieve and maintain asthma control. A literature search of PubMed was performed using the terms asthma, nurse practitioner, asthma control, burden, impact, morbidity, mortality, productivity, quality of life, uncontrolled asthma, NAEPP guidelines, assessment, pharmacotherapy, safety. Despite the increased morbidity and mortality and impaired quality of life attributable to uncontrolled asthma, the 2007 NAEPP asthma guidelines are greatly underused. NPs have an opportunity to identify patients at risk and provide enhanced care and education for asthma control. Often, NPs can prescribe medication for and manage these patients, but it is necessary to be able to discern which patients require referral to a specialist.

Asthma-Related Emergency Department Visits in North Carolina, 2010–2014

“…Collaborative efforts among health care providers and policymakers are needed to prioritize this issue to reduce asthma among high-risk populations and excessive asthma-related ED visits in North Carolina. Medical care providers are on the front-line of patient care and are in ideal positions to provide enhanced care and edu-cation for asthma control [30,31] and inform public policy to raise awareness in settings such as school environments [32,33]. …”

Practical guidance on the recognition of uncontrolled asthma and its management

“…Use of an asthma action plan, a set of instructions for daily management tailored to the individual patient, is recommended for all patients by several guidelines, including GINA (Global Initiative for Asthma, 2015) and NHLBI/NAEPP (National Heart, Lung, and Blood Institute & National Asthma Education and Prevention Program, 2007). A personal asthma action plan can help to empower patients and to improve adherence (Rance, 2011), enabling them to alter their treatment in response to change and to the level of asthma control. Written (Kaferle & Wimsatt, 2012), electronic (Zipkin, Schrager, Keefer, Marshall, & Wu, 2013), and phone-based (Raju, Soni, Aziz, Tiemstra, & Hasnain, 2012) action plans are all effective.…”

The Nurse Practitioners’ Perspective on Inhaler Education in Asthma and Chronic Obstructive Pulmonary Disease

“…In asthma and COPD, both specialist and nonspecialist nurses deliver much of the care that patients receive at primary, secondary, and tertiary levels, playing a key role in the majority of care programs, while in some settings, prescribing nurses also make treatment decisions and changes [ 8 ]. As frontline providers of patient care in asthma, nurses are often responsible for the ongoing evaluation of asthma control and for deciding the best treatment in collaboration with the patient and physician [ 9 ]. Nurses also play significant roles in most aspects of COPD management, including diagnosis, review and tracking of disease progression and treatment success, and instruction on treatment modification where required [ 10 ].…”

“…Nurses also play significant roles in most aspects of COPD management, including diagnosis, review and tracking of disease progression and treatment success, and instruction on treatment modification where required [ 10 ]. The National Asthma Education Prevention Plan (NAEPP) guidelines advocate that healthcare providers, including nurses, build a strong relationship with their patients through effective communication, answering questions, and supporting effective disease management [ 9 , 11 ]. These partnerships place nurses in a key position to recognize poor disease control and to provide enhanced care or specialist referral for high-risk patients [ 9 , 11 ].…”