Persistent asthma, preferred long term control medication or an acceptable alternative treatment, prescribed (NMA-No Measure Associated)
CPT4 code
Name of the Procedure:
Preferred Long Term Control Medication for Persistent Asthma Prescribed (NMA-No Measure Associated)
Summary
Prescribing long-term control medication for persistent asthma involves selecting and recommending appropriate treatments that help to manage and control asthma symptoms over an extended period. This can include various medications, typically inhalers, and occasionally oral medications, tailored to the patient's individual needs to prevent asthma exacerbations and improve quality of life.
Purpose
Medical Condition:
Persistent asthma, a chronic inflammatory disease of the airways characterized by recurring episodes of wheezing, breathlessness, chest tightness, and coughing.
Goals:
- Control and prevent asthma symptoms.
- Reduce the frequency and severity of asthma attacks.
- Improve overall lung function and quality of life.
Indications
- Patients diagnosed with persistent asthma.
- Individuals experiencing frequent asthma symptoms (e.g., more than twice a week).
- Patients with reduced lung function and nighttime symptoms.
- Anyone experiencing asthma symptoms that interfere with daily activities.
Preparation
- Discuss current asthma symptoms and frequency with the healthcare provider.
- Review current medications and any allergies.
- Undergo lung function tests such as spirometry if necessary.
- Keep an asthma symptom diary to provide detailed information to the healthcare provider.
Procedure Description
- Assessment: The healthcare provider evaluates asthma severity, symptom frequency, and impact on daily life.
- Selection of Medication: Based on assessment, a preferred long-term control medication is chosen, typically inhaled corticosteroids, long-acting beta agonists, or leukotriene modifiers.
- Prescription: The provider prescribes the medication and gives detailed usage instructions.
- Education: The patient receives education on proper inhaler technique and adherence to the medication regimen.
- Follow-up: Regular follow-up appointments are scheduled to monitor progress and make any necessary adjustments.
Duration
The initial assessment and prescription process typically takes one office visit, about 30-60 minutes. The treatment is ongoing and requires regular follow-up appointments.
Setting
- Outpatient clinic
- Primary care office
- Specialty clinic (e.g., pulmonology or allergy clinic)
Personnel
- Primary care physician
- Pulmonologist
- Allergist
- Nurse or Medical Assistant
- Pharmacist
Risks and Complications
- Common: Throat irritation, hoarseness, oral thrush (fungal infection), cough.
- Rare: Systemic side effects from high-dose inhaled steroids, increased risk of infections, adrenal suppression.
Benefits
- Improved control of asthma symptoms.
- Reduced frequency and severity of asthma attacks.
- Enhanced ability to perform daily activities and exercise.
- Better lung function and overall quality of life improvements often noticeable within weeks of consistent use.
Recovery
- Initial adjustment period to the medication regimen.
- Regular follow-up to ensure the treatment is effective and to make any necessary adjustments.
- Continuous use may be necessary; however, the regimen might be adjusted based on symptom control.
Alternatives
- Short-acting beta agonists (as rescue medications).
- Other long-term control options like oral corticosteroids (used sparingly).
- Biologic therapies for severe asthma.
- Pros and Cons: Long-term inhaled medications have fewer systemic side effects compared to oral corticosteroids but require regular adherence.
Patient Experience
- Inhaled medications are generally well tolerated.
- Initial side effects can include mild throat discomfort or cough.
- Consistent symptom control typically leads to a noticeable improvement in daily life activities.
- Pain management is generally not required, as the procedure involves medication administration rather than invasive techniques.