Who's Right for You?
Sometimes it might be easier to select the provider you've been seeing all along — for instance, your family physician or pediatrician — who may know you and your child's history. But while this provider may be excellent at treating your family members, you need to determine if the skills and demeanor are there to provide continuing care for an asthma patient. Some of the areas you also may want consider when evaluating a health care provider include:
Has she discussed developing a treatment plan or asthma action plan for your child — and reviewed the details?
Does she discuss possible allergens, irritants, or other medical conditions (such as gastroesophageal reflux disease, food allergies, or vocal cord dysfunction) that could cause your child's symptoms?
Does she explain what can happen to your child physically during an asthma attack, why the prescribed medications were selected, and when to seek emergency help?
Does she encourage physical activity and participation in most sports activities? And, does she let you know what you can do to prevent or reduce symptoms related to exercise-induced asthma?
Does she encourage you and your child to learn more about your asthma?
Does she offer reading pamphlets, booklets, videos, or local support group contact information?
Is the health care provider familiar with complementary and alternative therapies that you are interested in knowing more about? Could she recommend different providers?
The leading goal, though, should be does this health care provider emphasize prevention of asthma and what should be done every day to avoid an asthma attack? With careful treatment (and following a treatment plan that likely will evolve over time), many children with asthma — including yours — can achieve good asthma control.
The Therapeutic Relationship
Besides the right medications, an asthma health care provider should be able to keep your — and your child's — trust, and to promote what is called the therapeutic relationship. Both of you should feel comfortable when speaking to the health care provider, and he in turn must be sincere and honest with you — telling you the ups and downs of the medications being used and what the future holds for your child.
Establishing this type of relationship — where doubts or concerns can be expressed freely — helps set up a scenario where your child will strive for better understanding of his condition. This means avoiding situations that could trigger asthma attacks and being better able to deal with emergencies and severe asthma attacks without panic if they should occur.
Essential
Take the time to choose the asthma health care provider that you believe is right for your child. Try to build a good relationship — where you and your child feel confident to ask for advice or even to complain if something seems to be ineffective or uncomfortable. Asthma is a very individual condition, and what works for one child may not always work for another.
If you see that you are not achieving results with this health care provider, do let him know. Hopefully, you will be able to work it out. But, if this falls short, then consider another health care provider. Remember, all team players need to work together.
Guidelines
Also, you should know if your child's health care provider is familiar with current guidelines that are designed to promote better asthma outcomes among patients of all ages.
Every five years, the National Institutes' of Health National Asthma Education and Prevention Program (NAEPP) releases new health care provider guidelines that are based on the latest research on monitoring and treating asthma. These guidelines are designed to help providers deliver care that promotes good asthma outcomes.
Fact
Shortly before the latest guidelines were released in 2007, a study showed that only 20 percent of children with persistent asthma had a level of control that was considered optimal. These findings were surprising because if the guidelines — which address medications, environmental triggers, and action plans — were followed, the children should have experienced few or no asthma symptoms, including asthma flare-ups, according to the study.
Researchers found several potential reasons for this low level of control, including children not using the daily medication consistently, exposure to environmental triggers such as secondhand tobacco smoke or allergens such as mold, or receiving little education about what to watch out for or what to do in the case of an asthma attack.
Using those guidelines, a health care provider can help your child work toward controlling his asthma by making sure he is taking his medications properly and flagging those trouble areas that could trigger asthma. The ultimate goal should be a better quality of life (with few asthma symptoms).
Role as Educator
Asthma can be a condition that continually varies for a number of reasons. While most days can be great for your child in terms of controlling her asthma, certain days may not. Stress, changing environmental conditions, or even forgetting medications can modify your child's asthma symptoms.
A health care provider, plus members of her team, should be able to act as educators — providing guidance to you ahead of time on what symptoms to look for and what to do. This can be listed on your child's asthma action plan that the health care provider should help develop. (Also see Chapter 2.) The health care provider (along with colleagues or support staff) should also be available to answer questions and provide guidance and treatment if an emergency arises.
It is also helpful if the health care provider can speak to the child in terms that she'll understand about her lungs and airways, medicines, and peak flows. Asthma symptoms can be scary, but it can be reassuring for the child's provider to explain what asthma is and how it can be prevented.
