Chronic Conditions

Back to top


(Updated December 5th, 2018)

Asthma Definition:

Asthma is a chronic lung disease that inflames and narrows the airways. Asthma causes recurring periods of wheezing, chest tightness, shortness of breath, and coughing . The coughing often occurs at night or early in the morning. National Heart Lung and Blood Institute

Asthma Guidelines:

University of Michigan Health System, asthma care guidelines

Michigan Quality Initiative Consortium, asthma care guidelines 

Asthma Initiative in Michigan

Care Management Interventions

Click Here for an example of an Asthma action plan

Diagnosis Specific Concerns

Care Management Intervention

Patient Specific Interventions

Care Manager Quick Tools

Patient Quick Tools


Assess patients knowledge level on diagnosis

Preparing for the visit


Comprehensive Assessment tool

Comprehensive Assessment Tool - Pediatrics

What to Expect at the Physician Appointment


Handout - Preparing for the Appointment


Diagnosis Education

Provide education regarding asthma diagnosis

  • Causes
  • Risks
  • Symptoms
  • Treatment

Discuss diagnosis with care manager


Review educational materials provided


Provide teach-back

Asthma publications and fact sheets from the National Heart,  Lung and Blood Institute

Asthma Action Plan

Asthma Action Plan for Child 0-5 Years

Asthma Action in Michigan

Asthma Fast Facts for Kids

Understanding Asthma

Care Guide from the University of Michigan

Shortness of Breath

Discuss Asthma action plan


Keep an asthma journal


Work with care manager to establish personal goals of care

Asthma Initiative of Michigan

Michigan Asthma Resource Kit

Free asthma educational materials for adults and children from the Asthma and Allergy Foundation of America



Asthma Control Test

Triggers Discuss triggers Eliminate possible triggers at home and at work

Allergy Testing, FAQ

Removing Asthma Triggers EPA

How Lung Friendly is Your Workplace

Controlling Asthma at Work

Medication Management

Medication education

  • Inhalers
  • Oral agents
  • Nebulizer education

Provide teach back on inhaler use


Discuss side effects of medications


Discuss interactions

Demonstrate use of inhalers and spacers

Understand differences between short and long acting medications

Take medications as prescribed

Asthma Care Quick Reference from the National Institute of Health

Asthma Medication Card

Biological Treatments

Michigan Medicaid Spacer Policy



Using a Meter Dose Inhaler with Spacer

Using a Meter Dose Inhaler with Spacer Video - CDC


Educate on diet recommended by physician

Provide education on diet and tools for maintaining diet

Refer patient to a dietitian or nutritionist

Create diet plan

Demonstrate understanding of prescribed diet:

  • Rest just before eating.
  • Eat more food early in the morning if you're usually too tired to eat later in the day.
  • Avoid foods that cause gas or bloating. They tend to make breathing more difficult.
  • Eat 4 to 6 small meals a day. This enables your diaphragm to move freely and lets your lungs fill with air and empty out more easily
  • If drinking liquids with meals makes you feel too full to eat, limit liquids with meals; drink an hour after meals.

Nutrition for Better Breathing

Diet and Asthma



Healthy Diet

Diet and Asthma

Action Plan

Educate patient on when to call primary care physician


Provide patient with asthma action plan





Demonstrate understanding of asthma action plan and when to call physician’s office versus go to Emergency Room

Asthma Action Plan

Electronic Asthma Action Plans from Asthma Initiative of Michigan

Asthma Action Plan






Review smoking cessation literature


How to create a quit smoking plan


Quit Smoking - MDHHS

Asthma and Smoking



Instruct on activity level

Discuss exercise induced asthma

Review information regarding exercise

Develop an exercise plan with CM

Asthma and Physical Activity in School

Exercise Induced Bronchospasm - Clinicians



Activity Tracker

Exercise Induced Bronchospasm - Patients



Managing Stress

Educate patient on healthy ways to manage stress

Refer patient to a behavioral health specialist

Demonstrate understanding of healthy ways to manage stress

Breathing Problems: How to Control Stress

Stress and Inflammation with Exacerbations

How to Lower Your Stress


Four Ways to Deal with Stress: American Heart Association

Common Tests

Instruct patient on peak-flow

Pulmonary function test

Review test information

Complete tests as ordered by physician

Pulmonary Function Test for Health Care Professionals

Pulmonary Function Test for Patients


For a printable version of the care mangement interventions Click Here

*This chart is not meant to be an inclusive list of interventions or resources for care management but a starting point in working with patients with asthma. Always check with your practice regarding the use of guidelines, resources and education.



Asthma Pathophysiology

Information on the pathophysiology of Asthma from the National Heart, Lung and Blood Institute


Asthma Pathophysiology

Understanding Asthma Pathophysiology, Diagnosis and Management from American Nurse Today


This section provides information on various toolkits to assist with the care management of asthma patients.


Asthma Toolkit

Asthma toolkit from the American Academy of Pediatrics Virginia Chapter


Asthma Toolkit - Wee Breathers

Wee Breathers from the Asthma Allergy Foundation of America. Toolkit is designed for children, however works well with individuals as a low-literacy tool.


Asthma Guideline Implementation Steps & Tools

(GIST) program combines provider education and practice redesign to improve the use of asthma guideline-based care by clinicians. The materials condense the guidelines into five tools that include all of the age groups.

Care Management Learning Resources

This section is for care managers who would like to get additional more specific information relating to asthma.

Community Resources

Managing Asthma Through Case Management in Homes

Available in 5 Michigan communities and includes: home visits with environmental assessment; social worker help for psychosocial intervention; joint consultation with client, primary care provider and case manager; and a school, daycare or worksite visit as appropriate.

Clinical Guidelines

Clinical Care Guidelines

Asthma clinical care guidelines from Michigan Medicine



Michigan Asthma Resource Kit (MARK) from the Asthma Initiative of Michigan to assist health care professionals and their office staff members in caring for persons with asthma in accordance with nationally established guidelines.


Community Healthcare for Asthma Management and Prevention of Symptoms (CHAMPS)

A how-to guide on the implementation of the CHAMPS interventions. Includes education materials, questionaires and forms.


Michigan Department of Health and Human Services

Provides information related to primary care and chronic disease.


Asthma Care Quick Reference

Guidelines from the National Asthma Education and Prevention Program, US Depratment of Health and Human Services

Webinars and Presentations

MiPCT Webinar

Feb 20 2013

To receive a certificate of completion Click Here

Webinar replay video

Presented by

Karen Meyerson, MSN, RN, FNP‐C, AE‐C Tisa Vorce, RRT, MA