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7. Treating Modifiable Risk Factors

Common modifiable risk factors regarding medications include inhaler & spacer/Aerochamber® technique. 

Please refer to CM Asthma Device Quick Guide for list of inhalant therapies and proper technique. This guide includes a list of common asthma devices, technique for use, and reasoning for spacer use with inhalers.

A tool frequently used in asthma education is the asthma action plan to provide written guidance for parents and guardians on how to treat patient when well (green zone), when about to enter an exacerbation or during an exacerbation (yellow zone), or when an exacerbation requires urgent management (red zone).

Asthma Action Plan 

Asthma educators can assist with asthma education on asthma physiology, inhaler education, and asthma action plan education via our in-person asthma classes and online video asthma classes.

Asthma education

Indoor environmental triggers can be a source of poor asthma control. Common indoor triggers include pests, indoor pets, mold, and dust mites.  

Our Environmental Health Program and Healthy Homes Program have dedicated specialists who can assist with indoor environment assessments for asthma triggers in poorly controlled patients. Please refer to Important Resources Page on how to contact.  

Management of outdoor aeroallergen triggers can be an effective adjunct therapy for asthma management. These are reviewed under allergy immunotherapy.  

Known environmental triggers:

  • irritants
  • allergens
  • respiratory tract infections
  • pollens
  • exercise
  • dust
  • cigarette smoke
  • cockroach
  • strong scents
  • animal

Environmental tobacco smoke and vaping/e-cigarette smoke is a known asthma trigger. Please talk to patient and families regarding tobacco smoke and vaping as a trigger for asthma.  

Smoking Cessation for Caregivers

Information on this website includes: 

  • Video training in motivational interviewing and smoking cessation counseling
  • Links to quit resources for families
  • Training in creating MRN for caregivers and providing nicotine replacement therapy prescriptions

Risks related to secondhand smoke exposure:  

Secondhand Exposure Smokers
 
  • Development of asthma in pediatric1 patients from secondhand exposure

  • Enhanced inflammatory response to allergens2
 
  • Increased severity of symptoms

  • Increased ED visits and hospitalizations

  • Accelerated decline in lung function

  • Impaired response to glucocorticoids
  • Adherence tips - this is a printable list of tips for adherence that can be given to patients and families.
  • Nonadherence can be a significant barrier in asthma management 
  • Must be assessed at every clinic visit addressing asthma 
  • Rates of compliance with asthma medications have previously been studied as 30-70%3 

References:

  1. Quinto, Kenneth B. Environmental tobacco smoke exposure in children aged 3-19 years with and without asthma in the United States, 1999-2010. no. 2013. US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics, 2013.
  2. Diaz-Sanchez, David, Robert Rumold, and Genry Gong Jr. "Challenge with environmental tobacco smoke exacerbates allergic airway disease in human beings." Journal of allergy and clinical immunology 118.2 (2006): 441-446.
  3. Rand, Cynthia S., and Robert A. Wise. "Measuring adherence to asthma medication regimens." American Journal of Respiratory and Critical Care Medicine 149.2 (1994):69-76.
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