Refer to the information below to tailor the consultation for the participant based on their responses to the asthma self-efficacy questionnaire.
Challenges with medication
Ongoing symptoms
Asthma beliefs
Friends, family and school
Challenges with medication
Ongoing symptoms
Asthma beliefs
Friends, family and school
Challenges with medication
Ongoing symptoms
Asthma beliefs
Friends, family and school
Challenges with medication
Ongoing symptoms
Asthma beliefs
Friends, family and school
Challenges with medication
Ongoing symptoms
Asthma beliefs
Friends, family and school
Challenges with medication
Ongoing symptoms
Asthma beliefs
Friends, family and school
Challenges with medication
Ongoing symptoms
Asthma beliefs
Friends, family and school
Challenges with medication
Ongoing symptoms
Asthma beliefs
Friends, family and school
Challenges with medication
Ongoing symptoms
Asthma beliefs
Friends, family and school
Challenges with medication
Ongoing symptoms
Asthma beliefs
Friends, family and school
Challenges with medication
Ongoing symptoms
Asthma beliefs
Friends, family and school
Challenges with medication
Ongoing symptoms
Asthma beliefs
Friends, family and school
Challenges with medication
Ongoing symptoms
Asthma beliefs
Friends, family and school
Challenges with medication
Ongoing symptoms
Asthma beliefs
Friends, family and school
Challenges with medication
Ongoing symptoms
Asthma beliefs
Friends, family and school
Challenges with medication
Ongoing symptoms
Asthma beliefs
Friends, family and school
Challenges with medication
Ongoing symptoms
Asthma beliefs
Friends, family and school
Challenges with medication
Ongoing symptoms
Asthma beliefs
Friends, family and school
Challenges with medication
Ongoing symptoms
Asthma beliefs
Friends, family and school
Challenges with medication
Ongoing symptoms
Asthma beliefs
Friends, family and school
Challenges with medication
Ongoing symptoms
Asthma beliefs
Friends, family and school
Challenges with medication
Ongoing symptoms
Asthma beliefs
Friends, family and school
Challenges with medication
Ongoing symptoms
Asthma beliefs
Friends, family and school
Challenges with medication
Ongoing symptoms
Asthma beliefs
Friends, family and school
Challenges with medication
Ongoing symptoms
Asthma beliefs
Friends, family and school
Challenges with medication
Ongoing symptoms
Asthma beliefs
Friends, familly and school
Challenges with medication
Ongoing symptoms
Asthma beliefs
Friends, familly and school
Challenges with medication
Ongoing symptoms
Asthma beliefs
Friends, familly and school
Challenges with medication
Ongoing symptoms
Asthma beliefs
Friends, familly and school
Challenges with medication
Ongoing symptoms
Asthma beliefs
Friends, familly and school
Challenges with medication
Ongoing symptoms
Asthma beliefs
Friends, familly and school
Challenges with medication
Ongoing symptoms
Asthma beliefs
Friends, familly and school
Challenges with medication
Ongoing symptoms
Avoiding triggers
Successful communication
Challenges with medication
Ongoing symptoms
Avoiding triggers
Successful communication
Challenges with medication
Ongoing symptoms
Avoiding triggers
Successful communication
Challenges with medication
Ongoing symptoms
Avoiding triggers
Successful communication
Challenges with medication
Ongoing symptoms
Avoiding triggers
Successful communication
Challenges with medication
Ongoing symptoms
Avoiding triggers
Successful communication
Challenges with medication
Ongoing symptoms
Avoiding triggers
Successful communication
Challenges with medication
Ongoing symptoms
Avoiding triggers
Successful communication
Challenges with medication
Ongoing symptoms
Avoiding triggers
Successful communication
Challenges with medication
Ongoing symptoms
Avoiding triggers
Successful communication
Challenges with medication
Ongoing symptoms
Avoiding triggers
Successful communication
Challenges with medication
Ongoing symptoms
Avoiding triggers
Successful communication
Challenges with medication
Ongoing symptoms
Avoiding triggers
Successful communication
Challenges with medication
Ongoing symptoms
Avoiding triggers
Successful communication
Challenges with medication
Ongoing symptoms
Avoiding triggers
Successful communication
Challenges with medication
Ongoing symptoms
Avoiding triggers
Successful communication
Challenges with medication
Ongoing symptoms
Avoiding triggers
Successful communication
Challenges with medication
Ongoing symptoms
Avoiding triggers
Successful communication
Challenges with medication
Ongoing symptoms
Avoiding triggers
Successful communication
Challenges with medication
Ongoing symptoms
Avoiding triggers
Successful communication
Challenges with medication
Ongoing symptoms
Avoiding triggers
Successful communication
Challenges with medication
Ongoing symptoms
Avoiding triggers
Successful communication
Challenges with medication
Ongoing symptoms
Avoiding triggers
Successful communication
Challenges with medication
Ongoing symptoms
Avoiding triggers
Successful communicationChallenges with medication
Challenges with medication
- I know how to correctly use my asthma inhaler/spacer/medication
- Check inhaler is appropriate, e.g. delivers medication, fits lifestyle, patient can use. If necessary, retrain.
Online support for your patient: videos of correct use of inhalers, compare with a selfie video. - Consider a dry powder device perhaps switching to ART or MART therapy (see section at end of table).
- I know what my preventer inhaler is for. - I know what my reliever inhaler is for. - I know which of my inhalers I need to take.
- Revise knowledge of preventer(s) vs reliever, e.g. action, speed of action, when to use reliever (symptomatic and pre-exercise); when to use preventer, need for continuous use, need for medication. Online support for your patient: information about medication including when to use.
- Challenge incorrect beliefs about their asthma and using medication (e.g. effectiveness). Online support for your patient: Common concerns about asthma medicines | Asthma + Lung UK
- Check can apply knowledge using specific scenarios including being prepared, e.g. before sport.
- Use the opportunity to ask your patient about adherence – “How often do you forget your preventer inhaler?”.
If adherence poor, then see adherence section below.
- I know when to use my asthma medication
Adherence:
- Ask patient what they feel are consequences of not taking medication as prescribed; challenge as required OR discuss what they might be able to do if complied with medication regime.
- Ask your patient how they remember to do other things - personal reminders, routines and habits to that work for them – work out how they can use these to remember medication. Otherwise ask permission to make some suggestions, e.g.
- Leave your medication somewhere you can see it e.g. next to your toothbrush, by your bed, or next to your breakfast cereal
- Get into a habit of taking your medication just before you brush your teeth morning and night
- Set a reminder on your phone
- Set your morning alarm to get you up 5 minutes earlier
- Make a chart and tick off when you take medicines
- Use a pillbox (for tablets)
- Self-monitor, e.g. using a diary, and planning ahead.
- Goal setting regarding use of preventer(s), e.g. only miss once a week, check using the counter on the inhaler or using a diary.
Motivation and acceptance of taking medication:
- Discuss benefits of taking medication, e.g. being able to do things where they currently have limitations (such as sport)
- Ask them to remember when asthma was very well or very poorly controlled, think about the reasons for this.
Consider switching to ART or MART therapy to improve adherence:
- Online support for your patient: Your child's asthma medication :: Healthier Together
- Online support for HCP:
- Healthier Together ART and MART PAP:
- https://www.piernetwork.org/uploads/4/7/8/1/47810883/srt__1_.pdf
- https://www.piernetwork.org/uploads/4/7/8/1/47810883/action_plan_-_mart_symbicort_turbohaler_6-11.pdf
- https://www.piernetwork.org/#gsc.tab=0&gsc.q=action%20plan&gsc.sort=
- Children and young people asthma training for tier 3 providers: NHSE elfh Hub
- Helping to optimise adherence and self-management (Module 2: Practical organisation of transition and developing the key)
Consider switching to a once-a-day preventer, e.g. Relvar, to improve adherence.
Ongoing symptoms
- I can be prepared to deal with an asthma attack
- Can patient organise repeat prescription? Online support for your patient: Ordering Prescriptions - Moving on Asthma
- Ensure possess clothes or bag to carry medication.
- Goal plan situations where unlikely to have access to medication.
- Assist in empowering teenager to take responsibility and control of their asthma management - use action plan saved on phone.
- Online support for your patient: Asthma attacks | Asthma + Lung UK
- I can stay calm when I am having trouble breathing
- Identify best approach for individual patients to stay calm. This would include learning breathing techniques.
- Online support for your patient: Breathing Techniques – CAMHS
- I know when I am out of breath because of my asthma rather than because of exercise
- I know when I am out of breath because of my asthma rather than because I feel a bit panicky
- Discuss scenarios with different presenting symptoms such as: differences between asthma / dysfunctional breathing / panic / ‘out of breath’.
- Ensure teenager can recognise symptoms of each and knows how to respond to each.
- Online support for your patient: Breathing Techniques – CAMHS
Support for your patient – here are some ways to tell the difference between an asthma attack and a panic attack:
(Adapted from Beatasthma: https://www.beatasthma.co.uk/wp-content/uploads/2017/10/Asthma-and-Panic-Attacks-%E2%80%93-knowing-the-difference-pupil.pdf)
- I know how to control my asthma when I am having trouble breathing
- I know when to use my inhaler to manage a serious breathing problem
- I know when I might need to go to hospital becuase of a serious breathing problem
- Discuss how to manage various scenarios with different presenting symptoms.
- Refer to personal action plan. Online support for HCP - Healthier Together ART and MART PAP:
- Role play various scenarios where need to manage different symptoms e.g. preparations before playing sport, an asthma attack when out with friends.
- I know what to do to avoid triggers for my asthma
- Find out what patient thinks triggers their asthma – challenge if necessary.
- Ensure teenager has knowledge about personal triggers and how they can avoid them – e.g. identify their personal triggers and list in asthma management plan.
- Discuss strategies to minimise exposure, for example changes to physical environment (e.g. allergen reduction measures) or social environment (e.g. changing who they socialise with or where they socialise).
- Management plan for minimising impact of exposure to unavoidable triggers, e.g. increase medication pre-exposure.
- Aim for teenager to be able to avoid or reduce exposure to triggers. Scenarios – e.g. role play a situation which may lead to exposure to a trigger (e.g. friends are smoking), opportunity to demonstrate self-advocacy skills.
- Goal setting task – decide on the goal and aim to keep to it.
Asthma beliefs
- I am in control of my asthma
- I can do physical activity such as sports
- I can have a normal life
- I can do the things that I want to do
- I can control my asthma day-to-day
- Aim for teenager to be able to do things they would like. Discuss scenarios where planning to do an activity that might be expected to cause problems with their asthma. Talk through how to prevent issues and manage any symptoms that might arise.
- Goal setting task – decide on the goal and aim to keep to it.
- Assist in empowering teenager to take responsibility and control of their asthma management - use action plan saved on phone.
- Discuss how to manage various scenarios with different presenting symptoms.
- Role play various scenarios where need to manage different symptoms e.g. preparation before playing sport, an asthma attack when out with friends.
- Online support for your patient: Asthma attacks | Asthma + Lung UK
Would ART or MART be helpful in controlling asthma and normalising life?
- Online support for your patient: Your child's asthma medication :: Healthier Together
- Online support for HCP - Healthier Together ART and MART PAP:
- https://www.piernetwork.org/uploads/4/7/8/1/47810883/srt__1_.pdf
- https://www.piernetwork.org/uploads/4/7/8/1/47810883/action_plan_-_mart_symbicort_turbohaler_6-11.pdf
- https://www.piernetwork.org/#gsc.tab=0&gsc.q=action%20plan&gsc.sort=
Friends, family and school
- I can take my inhalers in front of my friends
- I can take my inhalers around other people at school
- Address any embarrassment or lack of confidence using medication.
- Information about celebrities with asthma for patient to use when talking to their peers about asthma to help “normalise”.
- Role play specific scenarios that the patient has / may face, e.g. being ridiculed when taking inhaler, conversation with peer about what it is like to have asthma.
- I can talk honestly to my friends about my asthma
- I can ask my firends for help if I am having trouble breathing or having an asthma attack
Aim for teenager to receive support from friends and peers.
- Discuss benefits of friends knowing about asthma and being available to assist self-management.
- Provide information that patient can pass to friends (What is asthma? | Asthma + Lung UK)
- Approach to dealing with peers; generally friends are understanding and want to be supportive. If necessary, be able to ignore negative reactions, e.g. role play.
- Resources for peers: Beat Asthma - how to manage a mild/moderate asthma attack. Beat Asthma - how to manage a severe asthma attack
- I can talk honestly to my parents about my asthma
- I can ask my parents for help if I am having trouble breathing or having an asthma attack
Aim for teenager to receive support from and communicate successfully with parents.
- Discussing how to re-negotiate relationship with parent: constructive use of reminders and / or advice from parents; encourage to take up responsibility from parents.
- Encourage parents to let go and give teenager increasing amounts of responsibility; parents should avoid abruptly expecting teenager to take complete responsibility.
- I can talk honestly to my doctor or nurse about my asthma
Aim to empower adolescent to take responsibility for their asthma and be confident when communicating with HCP.
- Transition teenager to see HCP alone for some of the consultation.
- HCP facilitating communication between them and patient.
- Practical tools to support communication, e.g. list of questions to ask HCP.
- Online support for your patient: Attending Reviews - Moving on Asthma.
- I can talk honestly to my teachers about my asthma
- I can ask my teachers for help if I am having trouble breathing or having an asthma attack
Aim for teenager to receive support from school.
- Self-advocacy skills, assertiveness, confidence. Learning how to communicate with teachers and advocate for themselves.
- Role play scenarios that allow them to demonstrate or explore how to advocate for themselves. Where necessary, HCP liaises directly with school.