Interventions for Asthma

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Age Cohort: Pregnancy and newborn

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Create awareness on Asthma including prevention measures Create awareness on the possible triggers/possible risk factors of asthma and how to avoid them Provide IEC materials on Asthma Multi sectoral approach to ensure clean environments Community Health workers training on Asthma including prevention measures	Guidance on Avoidance of asthma triggers including: indoor allergens (for example, house dust mites in bedding, carpets and stuffed furniture, pollution and pet dander) Outdoor allergens(such as pollens and moulds) Avoidance of tobacco smoking/cessation of smoking Avoidance of exposure to second hand smoke Avoidance of other triggers such as cold air, extreme emotional arousal such as anger or fear, and physical exercise. Avoidance of exposure to exhaust fumes or other types of pollution Avoidance of Exposure to occupational triggers, such as chemicals used in farming, hairdressing and manufacturing Having an elaborate plan for living with asthma and preventing asthma attacks Taking medication as per prescription to prevent attack Vaccination against influenza and pneumonia as flu and pneumonia can trigger flare ups Weight control through proper diet and exercise community level Surveillance to map the magnitude of asthma, and monitoring trends		Recognition of symptoms including Shortness of breath, Chest tightness or chest pain, Wheezing when breathing out,Trouble sleeping caused by shortness of breath,coughing or wheezing Seek emergency treatment–referral to a health facility Use quick relief inhaler asthma patients (as prescribed) Steam inhalation Guidance on use of medication as prescribed Guidance to patient on how to Monitor their breathing and how to recognize warning signs of an impending attack, such as slight coughing, wheezing or shortness of breath. Recognition of signs that asthma is probably worsening including, more frequent attacks, rapid worsening of difficulty in breathing or wheezing; shortness of breath when one is doing minimal physical activity
Primary Care
Create awareness on Asthma including prevention measures Create awareness on the possible triggers of asthma and how to avoid them Provide IEC materials on Asthma Health workers training on Asthma including prevention and management measures	Guidance on Avoidance of asthma triggers including: indoor allergens (for example, house dust mites in bedding, carpets and stuffed furniture, pollution and pet dander) Outdoor allergens(such as pollens and moulds) Avoidance of tobacco smoking/cessation of smoking Avoidance of exposure to second hand smoke Avoidance of other triggers such as cold air, extreme emotional arousal such as anger or fear, and physical exercise. Avoidance of exposure to exhaust fumes or other types of pollution Avoidance of Exposure to occupational triggers, such as chemicals used in farming, hairdressing and manufacturing Weight control through proper diet and exercise Having an elaborate plan for living with asthma and preventing asthma attacks Taking medication as per prescription to prevent attack Vaccination against influenza and pneumonia as flu and pneumonia can trigger flare ups Effective Surveillance to map the magnitude of asthma, and monitoring trends		physical and clinical examination Advice and guidance to the patient on recognition of asthma triggers, and how to avoid them Use of medications Quick-relief (rescue) medications for rapid, short-term symptom relief during an asthma attack. /inhalers Use Allergy medications Treatment of aggravating factors such as lower and upper respiratory tract infections Monitoring for any complications Referral to a hospital for further management of pregnant women with asthma including any complications
Referral Facility: General
Create awareness on Asthma including prevention measures Create awareness on the possible triggers of asthma and how to avoid them Provide IEC materials on Asthma Health workers training on Asthma including prevention and management measures	Guidance on Avoidance of asthma triggers including: indoor allergens (for example, house dust mites in bedding, carpets and stuffed furniture, pollution and pet dander) Outdoor allergens(such as pollens and moulds) Avoidance of tobacco smoking/cessation of smoking Avoidance of exposure to second hand smoke Avoidance of exposure to exhaust fumes or other types of pollution Avoidance of Exposure to occupational triggers, such as chemicals used in farming, hairdressing and manufacturing Avoidance of other triggers such as cold air, extreme emotional arousal such as anger or fear, and physical exercise. Guidance on Weight control through proper diet and exercise Guidance to patient to develop an elaborate plan for living with asthma and preventing asthma attacks Taking medication as per prescription to prevent attack Vaccination against influenza and pneumonia as flu and pneumonia can trigger flare ups Surveillance to map the magnitude of asthma, and monitoring trends		physical and clinical examination Diagnostic tests including Measure of lung function (Spirometry, Peak flow.) Methacholine challenge. Allergy testing. Either through a skin test or blood test Nitric oxide test to measure the amount of nitric oxide gas in the breath Sputum eosinophils Provocative testing for exercise and cold-induced asthma Imaging tests- chest x ray] Advice and guidance to the patient on recognition of asthma triggers and how to avoid them Use of medications -bronchodilator Quick-relief (rescue) medications for rapid, short-term symptom relief during an asthma attack. /inhalers Use Allergy medications Treatment of aggravating factors such as lower and upper respiratory tract infections Monitoring for and management of any complications Regular follow up
Referral Facility: Specialist
Create awareness on Asthma including prevention measures Create awareness on the possible triggers of asthma and how to avoid them Provide IEC materials on Asthma Health workers training on Asthma including prevention and management measures	Guidance on Avoidance of asthma triggers including: indoor allergens (for example, house dust mites in bedding, carpets and stuffed furniture, pollution and pet dander) Outdoor allergens(such as pollens and moulds) Avoidance of tobacco smoking/cessation of smoking Avoidance of exposure to second hand smoke Avoidance of other triggers such as cold air, extreme emotional arousal such as anger or fear, and physical exercise. Avoidance of exposure to exhaust fumes or other types of pollution Avoidance of Exposure to occupational triggers, such as chemicals used in farming, hairdressing and manufacturing Guidance to aptients on an elaborate plan for living with asthma and preventing asthma attacks Guidance on use of the medication as per prescription to prevent attack Vaccination against influenza and pneumonia as flu and pneumonia can trigger flare ups Guidance on Weight control through proper diet and exercise Effective Surveillance to map the magnitude of asthma, and monitoring trends		physical and clinical examination Diagnostic tests including Measure of lung function (Spirometry, Peak flow.) Methacholine challenge. Imaging tests- chest x ray] Allergy testing. Either through a skin test or blood test Nitric oxide test to measure the amount of nitric oxide gas in the breath Sputum eosinophils Provocative testing for exercise and cold-induced asthma Advice and guidance to the patient on recognition of asthma triggers and how to avoid them Use of medications -bronchodilator Quick-relief (rescue) medications for rapid, short-term symptom relief during an asthma attack. /inhalers Use Allergy medications Treatment of aggravating factors such as lower and upper respiratory tract infections Monitoring for and management of any complications Regular follow up

Age Cohort: < 5 years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Create awareness on triggers/ risk factors of asthma and preventive measures * Multi sectoral approach to ensure clean environments	Avoidance of aeroallergen Avoidance of direct or passive exposure to cigarette smoke	Recognition of asthma signs and symptoms	Short-acting beta-2 agonist.	Counselling on personalised asthma management Physical exercise	Emotional, social assessment and support based on cultural needs, values and preferences of parents and families
Primary Care
Health education on triggers/ risk factors of asthma and preventive measures	Avoidance of aeroallergen Avoidance of direct or passive exposure to cigarette smoke Vaccination against influenza and pneumonia	History Physical examination Response to asthma treatment trial	Short-acting beta-2 agonist. Inhaled steroids Long-acting beta-2 agonists Breathing techniques	Counselling on personalised asthma management Physical exercise	Emotional, social assessment and support based on cultural needs, values and preferences of parents and families
Referral Facility: General
Vaccination against influenza and pneumonia		History Physical examination Complete blood count Chest radiography	Short-acting bronchodilator, Low-dose inhaled corticosteroid (ICS) Long-acting bronchodilator (LABA) Long-acting muscarinic agonist (LAMA) Supplemental oxygen Bilevel Positive Airway Pressure (BiPAP) Counselling on personalised asthma management plan	Counselling on personalised asthma management Physical exercise	Emotional, social assessment and support based on cultural needs, values and preferences of parents and families
Referral Facility: Specialist
Health education on triggers/risk factors of asthma and preventive measures	Vaccination against influenza and pneumonia	History Physical examination Chest radiography	Short-acting bronchodilator, Low-dose inhaled corticosteroid (ICS) Long-acting bronchodilator (LABA) Long-acting muscarinic agonist (LAMA) Supplemental oxygen Bilevel Positive Airway Pressure (BiPAP)	Counselling on personalised asthma management Physical exercise	Emotional, social assessment and support based on cultural needs, values and preferences of parents and families

Age Cohort: 5 - 11 years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Create awareness on triggers/ risk factors of asthma and preventive measures * Multi sectoral approach to ensure clean environments	Avoidance of aeroallergen Avoidance of direct or passive exposure to cigarette smoke	Recognition of asthma signs and symptoms	Short-acting beta-2 agonist.	Counselling on personalised asthma management Physical exercise	Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families
Primary Care
Health education on triggers/ risk factors of asthma and preventive measures	Avoidance of aeroallergen Avoidance of direct or passive exposure to cigarette smoke Vaccination against influenza and pneumonia	History Physical examination Response to asthma treatment trial	Short-acting beta-2 agonist. Inhaled steroids Long-acting beta-2 agonists Buteyko or yoga breathing techniques	Counselling on personalised asthma management Physical exercise	Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families
Referral Facility: General
Health education on triggers/ risk factors of asthma and preventive measures	Vaccination: influenza Vaccination: pneumonia Vaccination: COVID	History Physical examination Complete blood count Chest radiography	Short-acting bronchodilator, Low-dose inhaled corticosteroid (ICS) Long-acting bronchodilator (LABA) Long-acting muscarinic agonist (LAMA) Supplemental oxygen Bilevel Positive Airway Pressure (BiPAP) Counselling on personalised asthma management plan	Counselling on personalised asthma management Physical exercise	Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families
Referral Facility: Specialist
Health education on triggers/ risk factors of asthma and preventive measures	Vaccination: influenza Vaccination: pneumonia Vaccination: COVID	History Physical examination Chest radiography	Short-acting bronchodilator, Low-dose inhaled corticosteroid (ICS) Long-acting bronchodilator (LABA) Long-acting muscarinic agonist (LAMA) Supplemental oxygen Bilevel Positive Airway Pressure (BiPAP)	Counselling on personalised asthma management Physical exercise	Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families

Age Cohort: 12 - 24 years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Create awareness on triggers/ risk factors of asthma and preventive measures * Multi sectoral approach to ensure clean environments	Avoidance of aeroallergen Avoidance of direct or passive exposure to cigarette smoke	Recognition of asthma signs and symptoms	Short-acting beta-2 agonist.	Counselling on personalised asthma management Physical exercise	Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families
Primary Care
Health education on triggers/ risk factors of asthma and preventive measures	Avoidance of aeroallergen Avoidance of direct or passive exposure to cigarette smoke Vaccination: influenza Vaccination: pneumonia Vaccination: COVID	History Physical examination Response to asthma treatment trial Pulse oximetry	Short-acting beta-2 agonist. Inhaled steroids Long-acting beta-2 agonists Buteyko or yoga breathing techniques	Counselling on personalised asthma management Physical exercise	Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families
Referral Facility: General
Health education on triggers/ risk factors of asthma and preventive measures	Vaccination: influenza Vaccination: pneumonia Vaccination: COVID	History Physical examination Pulse oximetry Complete blood count Chest radiography	Short-acting bronchodilator, Low-dose inhaled corticosteroid (ICS) Long-acting bronchodilator (LABA) Long-acting muscarinic agonist (LAMA) Supplemental oxygen Bilevel Positive Airway Pressure (BiPAP) Counselling on personalised asthma management plan	Counselling on personalised asthma management Physical exercise	Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families
Referral Facility: Specialist
Health education on triggers/ risk factors of asthma and preventive measures	Vaccination: influenza Vaccination: pneumonia Vaccination: COVID	History Physical examination Pulse oximetry Chest radiography	Short-acting bronchodilator, Low-dose inhaled corticosteroid (ICS) Long-acting bronchodilator (LABA) Long-acting muscarinic agonist (LAMA) Supplemental oxygen Bilevel Positive Airway Pressure (BiPAP)	Counselling on personalised asthma management Physical exercise	Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families

Age Cohort: 25 - 59 years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Create awareness on triggers/ risk factors of asthma and preventive measures * Multi sectoral approach to ensure clean environments	Avoidance of aeroallergen Avoidance of direct or passive exposure to cigarette smoke	Recognition of classic asthma symptom patterns	Counselling on recognition of symptoms Guidance to patient on how to monitor their breathing and how to recognize warning signs Guidance on use of medication as prescribed Recognition of danger signs and referral to the next higher level	Self-management education Physical exercise	Emotional, social, spiritual support
Primary Care
Health education on triggers/ risk factors of asthma and preventive measures	Avoidance of aeroallergen Avoidance of direct or passive exposure to cigarette smoke Vaccination: influenza Vaccination: pneumonia	History Physical examination Response to asthma treatment trial	Short-acting beta-2 agonist. Inhaled steroids Long-acting beta-2 agonists Buteyko or yoga breathing techniques	Counselling on personalised asthma management Physical exercise	Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families
Referral Facility: General
Health education on triggers/ risk factors of asthma and preventive measures	Vaccination: influenza Vaccination: pneumonia	History Physical examination Complete blood count Chest radiography	Short-acting bronchodilator, Low-dose inhaled corticosteroid (ICS) Long-acting bronchodilator (LABA) Long-acting muscarinic agonist (LAMA) Oxygen supplementation Bilevel Positive Airway Pressure (BiPAP)	Counselling on personalised asthma management Physical exercise	Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families
Referral Facility: Specialist
Health education on triggers/ risk factors of asthma and preventive measures	Vaccination: influenza Vaccination: pneumonia	History Physical examination Chest radiography	Short-acting bronchodilator, Low-dose inhaled corticosteroid (ICS) Long-acting bronchodilator (LABA) Long-acting muscarinic agonist (LAMA) Oxygen supplementation Bilevel Positive Airway Pressure (BiPAP	Counselling on personalised asthma management Physical exercise	Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families

Age Cohort: 60+ years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Create awareness on triggers/ risk factors of asthma and preventive measures * Multi sectoral approach to ensure clean environments	Avoidance of aeroallergen Avoidance of direct or passive exposure to cigarette smoke	Recognition of classic asthma symptom patterns	Short-acting beta-2 agonist.	Self-management education Physical exercise	Emotional, social, spiritual support
Primary Care
Health education on triggers/ risk factors of asthma and preventive measures	Avoidance of indoor, outdoor asthma triggers and smoking Avoidance of exposure to exhaust fumes or other types of pollution Vaccination against influenza and pneumonia to prevent trigger flare ups	History Physical examination Response to asthma treatment trial	Short-acting beta-2 agonist. Inhaled steroids Long-acting beta-2 agonists Buteyko or yoga breathing techniques	Counselling on personalised asthma management Physical exercise	Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families
Referral Facility: General
Health education on triggers/risk factors of asthma and preventive measures	Vaccination: influenza Vaccination: pneumonia	History Physical examination Complete blood count Chest radiography	Short-acting bronchodilator, Low-dose inhaled corticosteroid (ICS) Long-acting bronchodilator (LABA) Long-acting muscarinic agonist (LAMA) Oxygen supplementation Bilevel Positive Airway Pressure (BiPAP)	Counselling on personalised asthma management Physical exercise	Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families
Referral Facility: Specialist
Health education on triggers/ risk factors of asthma and preventive measures	Vaccination: influenza Vaccination: pneumonia	History Physical examination Chest radiography*	Short-acting bronchodilator, Low-dose inhaled corticosteroid (ICS) Long-acting bronchodilator (LABA) Long-acting muscarinic agonist (LAMA) Oxygen supplementation Bilevel Positive Airway Pressure (BiPAP)	Counselling on personalised asthma management Physical exercise	Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families