Interventions

A spacer (or valved-holding chamber) attaches to the inhaler. It holds the cloud of medicine in the chamber long enough for you to inhale it in one or two slow, deep breaths.

It may seem like carrying and using a spacer is more trouble than it's worth, but studies show that much more of the inhaler medication gets to the lungs (known as deposition) when using a spacer than without one. Learn more about spacers.

All quick-relief inhalers should be used with a spacer, and many of the long-term controller medications need them, too. Check to see if your inhaler needs a spacer.

If you are a member of any Michigan Medicaid health plan or are on straight Medicaid (fee for service), you can have up to 4 spacers/VHCs each year, at the pharmacy, with no prior authorization. Fee for service members can have any device that is Aerochamber® brand.

This infographic tells why spacers are important and how to get one through a Medicaid health plan.

Michigan public and nonpublic school children, under certain conditions, are allowed by law to carry and self-administer prescribed asthma and allergy medications on school grounds and during school-sponsored activities. This legislation ensure that students with asthma and allergies have immediate access to life-saving medications.

Specifically, the law does the following:
Permits a student to possess and use a metered dose inhaler or dry powder inhaler to alleviate asthma symptoms, or before exercise to prevent the onset of these symptoms at school or school sponsored activities and programs (e.g., school sponsored transportation; activities, events, or programs in which the student's school is participating). A student may also carry an epinephrine auto-injector or epinephrine inhaler to treat anaphylaxis. In order for the student to possess and use their inhaler, the student must have written permission from his or her physician, and parent (if under 18), and the principal must have copies of both approvals.

Read the actual law.

Michigan Law allows students to carry a rescue inhaler in school to treat asthma symptoms, as long as certain conditions are met.

Learn more about the conditions and the law with this Fact Sheet.

The FLARE plan is a comprehensive and concise tool to help emergency department patients receive discharge instructions based on the National Heart, Lung, and Blood Institute (NHLBI) asthma guidelines for asthma management. It has been distributed to all Michigan EDs, and has been adopted by three national EMR companies. The instructions include:

• A simple short-term asthma management plan to be used until the patient sees their primary care provider
• A basic asthma information sheet designed to be a teaching guide at discharge and for supplemental information once home. Both are written at a sixth grade level.

Does your local hospital use guideline-based discharge instructions? If not, recommend the FLARE.

Serving adults and children, the MATCH model of home-based asthma case management includes physician care and school/work visits, carried out by certified asthma educators, and social work involvement. Programs are reimbursed for services by some health plans.

This model of care is available in the Grand Rapids, Flint, Detroit, Ann Arbor and Lansing areas; new programs are in the planning stages.

You are eligible for this service based on the number of hospital or Emergency Department (ED) admissions, unscheduled physician visits, and missed days of school or work. Clients who have gone through this program experience:

• 83% decrease in hospitalizations
• 60% decrease in ED visits
• 58% decrease in nights awake
• 63% decrease in missed work days
• 40% decrease in missed school days

For a comprehensive look at MATCH, including detailed information on outcomes and sustainability, download the MATCH whitepaper.

The Asthma Guideline Implementation Steps & Tools (GIST) project was funded in 2010 by the National Asthma Control Initiative (NACI) to develop a program that makes it easier for primary care clinicians to use the NHLBI asthma guidelines in their everyday care of patients with asthma. The Michigan Department of Community Health gathered a statewide team of experts in asthma and practice redesign, and created a set of tools and a program to implement them.

GIST includes patient and provider diagnosis tools, provider follow-up tool, stepwise management tool and many more resources.

Download the GIST materials