Of patients in Connecticut who have a diagnosis of asthma, almost half have uncontrolled asthma.1
HUSKY Health supports guidelines from the National Asthma Education Prevention Program to improve asthma control for HUSKY members. The Guidelines Implementation Panel (GIP) Report for: Partners Putting Guidelines Into Action identified six clinical practice recommendations to assist providers with the implementation of the guidelines.
To help you quickly reference the GIP recommendations and access corresponding resources assembled by HUSKY Health, please use the below information when caring for your HUSKY patients with asthma.
|GIP Clinical Practice Recommendations||Asthma Control Resources|
|Assess asthma severity at the first visit to determine initial treatment.||For information on assessing asthma severity, access the Asthma Care Quick Reference guide here.|
|Use inhaled corticosteroids as recommended to control asthma.||
The Asthma Medication Ratio (AMR) can help you to assess your patient’s ability to take asthma medications as prescribed. To use our AMR calculator, click here.
If a patient has an AMR under 0.5, consider referring them to Intensive Care Management (ICM) for additional support with resolving barriers to medication use. To learn more about ICM, click here.
|Use written asthma action plans to guide patient self-management.||
Asthma Action Plans from the Connecticut Department of Public Health are available below.
You can complete these forms electronically and print them for your use. For instructions on how to complete an Asthma Action Plan, click here.
|Control exposure to allergens and irritants that worsen the patient’s asthma.||To assist you with assessing and controlling environmental triggers for your HUSKY patients, ICM can arrange a home visit to help members manage allergens and irritants in their environment. To refer a patient to ICM, fill out the ICM Referral Form and fax it to 866.361.7242.|
|Schedule follow-up visits at periodic intervals.||Patients may have trouble keeping follow-up appointments. HUSKY Health offers services to help manage patients with barriers to care, including:
|Assess and monitor asthma control at each follow-up visit and adjust treatment if needed.||The Asthma Control Test can help you assess and monitor asthma control:|
Intensive Care Management (ICM) offers services to help your patients stay on track between appointments. To learn more about ICM, click here.
To refer a patient to ICM:
To help you identify patients in need of care, HUSKY Health provides reports on members attributed to your practice through our secure provider portal. Emergency Department (ED) Utilization reports can help you identify patients who have visited the ED for asthma complications and now require follow-up.
To login for access to these reports, click here.
AMR is an important measure used to help you assess asthma medication use for your patients. The ratio compares the number of controller and rescue medications used by your patients. According to research on AMR and ED utilization, “Providers and payers can use this ratio in real time to identify at risk patients so that they can intervene to improve controller medication use and therefore prevent emergent healthcare visits."2
To calculate AMR, use information gathered from patient interview, EMR data, and/or from Surescripts for the past 6 months. The medication history provided through Surescripts can help you better assess prior medication use during current treatment planning. You may access Surescripts through your existing e-Prescribing system.
A list of e-Prescribing vendors and applications certified for integration with Surescripts is available at: http://www.surescripts.com/certification-status.html. If you are currently using a Surescripts certified e-Prescribing system, contact your e-Prescribing vendor for more information on connecting to the Surescripts network.
Enter your patient's total units of rescue medications and their total units of controller medications in the fields below to get their AMR.
An AMR less than 0.5 is a strong indicator that a patient may benefit from a discussion about their current medication usage.3
Example: You see a patient and you prescribe her a one-month supply of an asthma controller medication with five refills. You also prescribe a one-month supply of an asthma rescue medication with five refills. Data shows that the patient filled her controller medication twice and the rescue medication six times during the six-month period. Thus, the patient’s AMR is: 2/(2+6) = 0.25.
1 Centers for Disease Control and Prevention. Uncontrolled asthma among persons with current asthma. 2014. http://www.cdc.gov/asthma/asthma_stats/uncontrolled_asthma.htm
2 Andrews AL, Simpson AN, Basco WT, and Teufel, RJ. Asthma medication ratio predicts emergency department visits and hospitalizations in children with asthma. Medicare Medicaid Research Review. 2013; 3(4). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4011648/
3 Agency for Healthcare Research and Quality. Asthma medication ratio: Percentage of members 5 to 85 years of age who were identified as having persistent asthma and had a ratio of controller medications to total asthma medications of 0.50 or greater during the measurement year. 2015. https://www.qualitymeasures.ahrq.gov/content.aspx?id=49708
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