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Welcome to Guidelines :
 This section provides you with
direct access to information about the latest
pediatric and adult clinical guidelines used to support asthma care here in
Massachusetts and across the country. Also, included here are links to
other resources to help healthcare professionals choose and use
guidelines wisely.
News
from the National Heart, Lung & Blood Institute -
"Improving
Asthma Control Trial (IMPACT)"
New NHLBI Study to Identify People with Mild Persistent Asthma
The National Heart, Lung & Blood Institute (NHLBI) of the
National Institutes of Health announced the beginning of a study
to determine the best long-term strategy for treating adults
with mild asthma who experience symptoms more than
occasionally. The 2-year "Improving Asthma Control
Trial (IMPACT)" is designed to determine whether
these patients should be taking anti-inflammatory medications on
a daily basis and whether a newer class of medications provides
the same benefits as older drugs.
According to NHLBI Director Dr. Claude L'enfant, "This
study has major implications for the long-term health of these
patients. We know that daily anti-inflammatory therapy has
benefits, but we don't know whether daily use is really
necessary for people with mold asthma. This study should
provide the answer. Obviously, the study has also
substantial cost implications.
In the IMPACT study, 234 adults with mild asthma who have more
than occasional symptoms will be enrolled in six clinical
research centers. Following an initial evaluation,
patients will be randomized to receive either a twice-daily
inhaled corticosteroid, a twice-daily anti-leukotriene, or a
placebo. All patients will receive treatment for symptoms
if and when they occur. The results should demonstrate
whether medication is required on a daily basis by these
patients, and if do, whether inhaled corticosteroids and leukotriene
modifiers are equally effective.
The study is being conducted by NHLBI's Asthma Clinical
Research Network. The centers that participate in the
Network are: Brigham and Women's Hospital, Boston; Harlem
Lung Center, New York City; National Jewish Medical and
Research Center, Denver; University of Wisconsin,
Madison; Jefferson Medical College, Philadelphia;
University of California, San Francisco. The data
coordinating center is the M. S. Hershey Medical Center,
Hershey, PA.
The medications for IMPACT are being donated by Astra-Zeneca
Pharmaceuticals. For more information about IMPACT,
contact the NHLBI Communications Office at 301-496-4236,
or the nearest participating center.
 Acrobat
Reader required to view PDF files
(Download
Reader)
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Adult Asthma
Guidelines
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Guidelines
for the Diagnosis and Management of
Asthma:
Expert Panel Report #2
(PDF File)
National
Asthma Education &
Prevention Program of the National Heart, Lung & Blood
Institute (NHLBI) |
State-of-the-art clinical practice guidelines for diagnosing and managing
asthma and incorporates the most recent scientific
information available on the care of patients with
asthma. Provides information on treating asthma at all
severity levels and stresses both clinical & self-
management strategies. The guide also provides a
comprehensive discussion of current medications and
their appropriate use.
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Practical
Guide for the Diagnosis
and Management of
Asthma
(PDF
File)
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The
concise Practical Guide was designed to help the busy
primary care clinicians implement the recommendations of
the National Asthma Education & Prevention Program's 1997 clinical practice guidelines (Expert
Panel Report #2). |
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Emphasizing practical information, it outlines key
actions clinicians and patients can take to effectively
work together in managing asthma. A variety of
implementation aids are provided, including medication
dosage charts, glossaries of medication brand names,
patient self-assessment forms, and several reproducible
patient handouts. |
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Pediatric
Asthma Guidelines |
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Pediatric
Asthma:
Promoting Best Practice: A Guide for
Managing Asthma in Children
(Download
Link)
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Pediatric Asthma Workgroup of the New England Managed
Care/Public Health Collaborative is recommending the use
of this tool as a resource for developing & managing
comprehensive asthma management plans. |
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The NAEEP's 1997 Expert Panel
Report provides rich information for the diagnosis and
management of asthma. To help family practice
physicians, pediatricians, nurse practitioners, and
others who treat children with asthma, the initiative is
adapting the report into a pediatric focused document --
Pediatric Asthma: Promoting Best Practice Guidelines
for Managing Asthma in Children. This easily
referenced, user-friendly guide will advance the goal of
standardized, quality care.
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Other
Guidelines |
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Blue
Cross & Blue Shield of Massachusetts
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Blue
Cross & Blue Shield of Massachusetts has its asthma
guidelines available by fax at 1-888-633-7654.
Select Option #1 and enter ID# 6010. Their medical
policy for respiratory devices is available on their
website.
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Baystate
Health Systems' Office of Clinical Practices Evaluation
& Management has developed Adult and Pediatric
Asthma Clinical Practice Guidelines for effective and
efficient management of asthma. The large volume of
admissions for asthma exacerbations and variations in
practice style were the impetus to develop a quality
management approach. The key points for each
guideline are listed below:
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Each
clinical practice guideline, including physician order
sets is available for a $50.00 fee. There is no charge
for providers with admitting privileges within the
Baystate Health System.
To
request a copy of complete guideline, send a check or
money order made payable to Baystate Medical Center
and mailed to:
Lori Cohen
Clinical Outcomes Coordinator
Baystate
Medical Center
OCPEM Porter 5
759 Chestnut Street
Springfield, MA 01199
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Don't
forget to include your name, mailing address, telephone
number and title of guideline.
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Other
Resources to Choose & Use Guidelines |
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National
Guidelines Clearinghouse
(Download by Disease Link)
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The
National Guideline ClearinghouseTMT (NGC) is
a public resource for evidence- based clinical practice
guide- lines. NGC is sponsored by the Agency for Healthcare
Research and Quality (AHRQ) in partnership
with the American Medical Association and the American
Association of Health Plans.
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Pocket
Guide for Asthma Management & Prevention
(PDF file)
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A pocket guide to global strategies for asthma management and
prevention. An NHLBI & World Health Organization Workshop
Report.
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Breathe
Easy Asthma
Care Benefit
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Tufts
Health Plan's Breathe Easy Asthma Care Benefit is
designed to help improve the medical management of
asthma through assessment of educational needs and the
home environment. This benefit focuses on the newly
diagnosed, the pediatric member, and those members who
find it difficult to control their condition. However,
physicians can refer anyone whom they believe will
benefit from the intervention.
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Pediatric
Asthma Workgroup
New England Managed Care / Public Health Initiative
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The
regional office of Health and Human Services has
convened managed care and public health leaders from
around New England to discuss sharing strategies for
disease improvement. The Pediatric Asthma
Workgroup is developing recommendations for sharing
guidelines, performance measures, and practice
resources.
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Reports of
Interest |
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Asthma
and the Environment: A Strategy to
Protect Children (PDF)
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This report discusses asthma in children and
recommends a strategy to protect children from
environmental risk factors that worsen their
asthma. Recommendations cover research, programs to
improve public health, and addresses
disproportionate impacts on the poor and
minorities.
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Action
Against Asthma:
A Strategic Plan for the Department of Health and Human
Services
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The
U.S. Department of Health and Human Services' special
asthma initiative (May 2000) was developed to assess current
efforts on asthma and to develop a set of priorities for
the future. This strategy identifies the urgent need for
research to uncover the causes of the asthma epidemic
and develop ways to prevent the disease from occurring.
The strategy also describes priority public health
actions needed to eliminate the disparities in the
burden of asthma and to reduce the impacts on all who
suffer with the disease.
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Clearing
the Air:
Asthma & Indoor Air Exposures (PDF)
Copies of report are
available from the National
Academy Press or
call (202) 334-3313 / 1-800-624-6242. |
The
study was funded by the U.S. Environmental Protection
Agency. The Institute
of Medicine is a private, nonprofit organization
that provides health policy advice under a congressional
charter granted to the National Academy of Sciences.
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