INHALE's Initiatives
The INHALE Coordinating Center has identified several key areas to kick off quality improvement for improving care and outcomes in asthma and COPD. As the collaboratives grows and becomes more established the direction of our efforts will be driven by our data and a future steering committee.
Our guiding principles for the initial quality improvement targets include the following:
Improve Patient Outcomes
- Disease control is essential and achievable and must be assessed in a consistent and objective way.
- Exacerbations can be prevented and treated with strategies that do not rely exclusively on oral corticosteroids. Exacerbation prevention is of paramount importance when managing asthma and COPD.
Over Reliance on Medication
- Short-acting beta agonist (SABA) over-reliance is prevalent and increases the risk of exacerbations therefore it should be identified and steps should be taken to reduce excessive use of SABA.
- OCS overuse is associated with toxicities and accelerated development of multiple co-morbidities and OCS stewardship is desperately needed.
Patient and Provider Education
- Provider and patient education and engagement is essential in achieving successful implementation of guidelines and enacting behavior change that will be required to improve the outcomes of obstructive lung diseases in the state of Michigan.
- The INHALE CQI will include a comprehensive education campaign and patient representatives and caregivers of those with asthma and COPD will be recruited to participate in the CQI.
Spirometry Access and Use
- Spirometry is essential in the diagnosis and management of both asthma and COPD:
- GINA Guideline recommendations (asthma): measure lung function at diagnosis/start of treatment, 3-6 month after starting controller treatment, then periodically (at least every 1-2 years, but more in at-risk patients and those with severe asthma).
- GOLD Guideline recommendations (COPD): spirometry should be used to: establish diagnosis using post bronchodilator spirometry, used to assess severity of airflow obstruction, follow-up assessment to direct therapeutic decisions, identification of rapid decline.
