Asthma is a chronic inflammatory disease of the airways that causes recurrent episodes of wheezing, breathlessness, chest tightness, and coughing. Asthma can be difficult to diagnose and to differentiate from other respiratory illnesses, such as chronic obstructive pulmonary disease. Asthma ranges from mild intermittent to severe persistent, death can occur if not treated. The health care system is a patients’ first contact for reliable asthma education. Asthma can be managed with proper diagnosis, use of prescribed long-term controller and quick-relief medications, and reduction of exposure to environmental triggers. Every individual with asthma has different environmental triggers and it is vital to identify these triggers to reduce asthma episodes. Communication between patients and medical providers is key to managing asthma. Through education and understanding, people with asthma can lead healthy, active lives.

The Indiana State Department of Health conducted statewide randomized telephone survey that is population-based for individuals 18 years and older to determine the asthma burden in Indiana. According to the BRFSS, approximately 7.5 percent of Hoosiers 18 years and older currently have asthma. The costs of asthma, direct and indirect, are high. Direct costs include physician visits, medications, and hospitalizations. Each Hoosier with asthma spends $1,000-$8,000 per year on direct costs. Conservatively, Hoosiers spend approximately $500 million annually in direct costs. Indirect costs, such as depression, stress, and lose of sleep are more difficult to measure. People with asthma often have a poor perception of their health. Asthma is a major contributor to lost productivity, causing thousands of lost work and/or school days each year.

Asthma rates are higher for young boys and adult women. Further, the asthma burden falls disproportionately on African-Americans, individuals in a lower economic status and/or individuals with less than high school education level in Indiana. Currently, there are approximately 43,400 individuals diagnosed with asthma on Medicaid. The primary source of care for individuals with current asthma is their physicians’ office, approximately 75 percent. However, the other 25 percent of the individuals polled stated their primary source of care is a hospital emergency room, a public health clinic, an urgent care center, or hospital outpatient. Thus it is important to provide asthma educational materials at any point of contact, such as an Asthma Action Plan, information about asthma triggers and reducing exposure, and how to properly dispense medications.

• Physicians, Physician’s Assistants, and Nurse Practicioners

• Nurses, Licensed Practical Nurses

• Respiratory Therapists

• Pharmacists

• Emergency Room Staff

• School Nurses & Health Aides

• Public Health Workforce

• Social Workers

• Insurance Agents

• Training

• Resources

• Questions to Identify Triggers

• Environmental Asthma Triggers

• Asthma Action Plan

• School Contract

Allergy Skin Test

It is important to determine a patient’s sensitivity to indoor allergens. Medical history and specific questioning about a patient’s indoor allergen exposure are suggestive, but an allergy skin or in-vitro test is necessary to obtain sufficient evidence of allergen sensitivity. These tests determine the presence of specific IgE, but do not show if exposure to the allergen is the cause of the patient’s asthma symptoms. This is why patients need only be tested for the allergens they are exposed to.