Last Updated: May 2020

Author: Asthma Program, Vermont Department of Health

The data for this performance measure was available through 2010, then graduated from the survey.  The current data reflects preliminary data for 2015/2016 after the question was reinstated into the ACBS survey.  The percent of Vermont’s children with a written asthma management plan has fluctuated considerably within the time period of data available (2006-2010), with the Healthy Vermonters 2020 goal in Vermont set at 65% of children with an asthma management plan.  The numbers fluctuated between 46% and 66%. In recent years, there has been a decreasing number of respondents for the Child Asthma Callback Survey; this is a problem that several other states are also facing and accounts for why the the question was suspended temporarily in 2010. The achievement of 52% of up-to-date asthma action plans in 2016 reflects work of the state Asthma Program to target specific regions and schools with higher hospitalization and/or emergency room visits in an effort to improve action plan use in areas of disparate asthma burden.  The importance of asthma action plans have been reinforced through an annual school nurse training for those interesting in implementing Open Airways for Schools (OAS), an interactive self-managment education program for children.  The spike from 2006-2007 is thought to coincide with the release of the National Guidelines for the Diagnosis and Management of Asthma (EPR-3 Guidelines).

Asthma self-management education is essential to reducing asthma-related adverse health effects. Asthma education also improves a patient’s quality of life by reducing urgent care visits, emergency department visits, hospitalizations, and healthcare costs.¹

Healthcare professionals should provide asthma self-management education to patients with asthma and their families or caregivers. This education should include a discussion of environmental triggers. In addition, every patient with asthma should be given a written asthma action plan providing instructions for daily asthma management and for recognizing and handling worsening asthma. A major emphasis of the Program is to promote guideline-based care and having an up to date asthma management plan.¹ Overall in the United States, children (49%) were more likely to report having an asthma action plan compared with adults (27%).² Vermont children had a significantly higher receipt of asthma action plans compared to children nationwide (2006-2010 combined data).³

This indicator is part of Healthy Vermonters 2020 (the State Health Assessment) that documents the health status of Vermonters at the start of the decade and the population health indicators and goals that will guide the work of public health through 2020. Click here for more information.

1. Douglass J, et al. BMJ 2002;324:1003–5.
2. http://www.cdc.gov/asthma/pdfs/asthma_facts_progra...
3. www.cdc.gov/asthma/acbs/acbstables.htm

• Maternal and Child Health is a division in the Department of Health that works with the Vermont Asthma Program on increasing coordination at schools and among school nurses to address absenteeism and asthma education for school nurses/students, including training school nurses in selected supervisory unions throughout the state on asthma self-management.
• Blueprint for Health is a partner that works with the Vermont Asthma Program on educating community health teams on asthma education and tools available to improve self-management, including Asthma Action Plans and Healthier Living Workshops that support improving asthma management.
• Rutland Regional Medical Center is a partner that works with the Vermont Asthma Program on home visiting programs, the MAPLE hospital discharge protocol and community education.
• DVHA is a partner that works with the Vermont Asthma Program on reducing the burden of asthma among Medicaid-insured including exploring reimbursement for community-based education.
• Vermont Department of Health Offices of Local Health are partners that work with the Vermont Asthma Program to disseminate asthma action plans and reach local communities
• Asthma Advisory Panel is a partner that works with the Vermont Asthma Program on developing strategic goals and relationships.
• Asthma Regional Council is a partner that works with the Vermont Asthma Program on facilitating meetings between the different New England Asthma Programs
• Northeast American Lung Association is a partner that works with the Vermont Asthma Program on supplying education materials to asthma educators within the state.
• University of Vermont: Pediatrics is a partner that works with the Vermont Asthma Program on expanding access and delivery of supplementary asthma self-management education to those with uncontrolled asthma and severe persistent asthma to prevent asthma-related emergency department visits and hospitalizations.
• Vermont Chronic Care Initiative is a partner that will work with the asthma program on incorporating asthma education into their case management home visiting programs
• Vermont One Care is a partner that works with the Vermont Asthma Program at improving care for pediatric and adult populations by hosting a learning collaborative and facilitating quality improvement projects among participating providers and practices in guideline care.
• Hark Website Design, Branding & Communication is a partner that works with Vermont Asthma Program creating a digital media plan with the goal of increasing awareness of secondhand smoke exposures, increasing referrals to 802Quits, promoting importance of flu shots and asthma action plans, and reducing exposures to asthma triggers in homes and schools.

In 2007, the National Asthma Education and Prevention Program (NAEPP), coordinated by the National Heart, Lung, and Blood Institute (NHLBI), released its third set of clinical practice guidelines for asthma. The Expert Panel Report 3—Guidelines for the Diagnosis and Management of Asthma (EPR-3) reflects the latest scientific advances in asthma drawn from a systematic review of the published medical literature by an NAEPP-convened expert panel. It describes a range of generally accepted best-practice approaches for making clinical decisions about asthma care. Having an asthma action plan is very important in these guidelines.

The Vermont Asthma Program is working with other New England state programs through the Asthma Regional Council to explore if there is a provider training program that all states could collaborate on to improve outcomes including use of asthma action plans. Additionally, the Program holds or contributes to provider learning collaboratives to educate on guideline care and support for quality improvement in areas with higher hospitalization and/or emergency room visits due to asthma. The Vermont Asthma Program also works to disseminate asthma action plans which are a validated tool for educating patients on how to manage asthma. The Program is in Year 3 of a M.A.P.L.E plan initiative in Rutland and Springfield aimed to help lower rates of hospitalization and readmission by forming plans for asthma management post hospital discharge. We will continue to support the Rutland Pediatric in home visiting program and are working on a similar program in the Springfield area. The Easy Breathing initiative is used by several pediatricians in Burlington and aids in the diagnosing of asthma and providing guideline care. The Asthma Program is also working with the Vermont Chronic Care Initiative to educate and support their case managers to administer an asthma control test and demonstrate effective medication use. Lastly, the Asthma Program will work with schools to train school nurses on asthma self-management and proper medication use so that school nurses can pass that knowledge onto those students who have missed school due to asthma.

Data is updated as it becomes available and timing may vary by data source. For more information about this indicator, click here.