Asthma
ASTHMA CYCLE OF CARE
The Asthma Cycle of Care is a tool for General Practitioners to assist people with moderate to severe asthma to improve asthma management and quality of life through an ongoing cycle of best practice asthma management. The Asthma Cycle of Care replaces the Asthma 3+ Visit Plan.
The Asthma Cycle of Care involves at least two visits to a GP over a period of 12 months. These visits will include:
- diagnosis and assessment of asthma severity and level of control
- development of a written asthma action plan
- provision of information and patient self-management education
- review of asthma management and the written asthma action plan
Patient Eligibility
- Patients must have moderate to severe asthma.
- wheeze or cough on most days or at night
- have frequent asthma attacks
- use a reliever medication more than three times per week
- use preventer medications
- have attended or been admitted to hospital due to their asthma (ibid)
The Asthma Cycle of Care includes:
- At least two asthma related consultations in four weeks (min) to 12 months (max)
- At least one of these consultations should be a review consultation that was planned at a previous visit
- These visits must include:
- Documentation of diagnosis and assessment of asthma severity and level of control
- Review the patient’s use of, and access to, asthma related medication and devices
- Provision of a written asthma action plan (or documented alternative if the patient is unable to use a written action plan)
- Provision of asthma self management education
- Review the written or documented asthma action plan
All visits should be billed under the normal attendance items with the exception of the visit that completes the Asthma Cycle of Care. (Dept of Health & Ageing “Completing the Asthma Cycle of Care — A guide for General Practitioners”) When you have completed an Asthma Cycle of Care you may claim using the appropriate Medicare item numbers listed below:
|
Aspect or Activity
|
|
Annual Payments per SWPE*
|
|
|
Sign-on payment
|
N/A
|
$0.25
(per FTE GP)
|
One-off payment only
Practice must be registered for PIP
|
|
Asthma Cycle of Care – completion
|
Level B – 2546 & 2547
Level C – 2552 & 2553
Level D – 2558 & 2559
|
$100
per patient PLUS
consultation fees
|
These item numbers should be used in place of the
usual attendance items, when a consultation completes the minimum requirements for the Asthma Cycle of Care
The Asthma Cycle of Care targets patients with moderate to severe asthma.
*The average FTE GP sees 1,000 SWPEs annually
(Australian Government- Medicare Australia PIP Formula 2007)
SWPE Standard whole patient Equivalent
|
ASTHMA MANAGEMENT PLANS
Asthma Management Plans are built in to most Practice software, guidelines are available from the National Asthma Council Australia.
PRACTICE NURSE AND ASTHMA CYCLE OF CARE
A Practice Nurse can be used to assist GPs with the Asthma Cycle of Care. The Practice Nurse can provide patient education, record peak-flow or spirometry results; take detailed patient and medication history; and review device techniques. The following is an example of a general practice utilising practice nurses for the best implementation of the 3+Plan.
Visit 1 - Practice Nurse and GP
- Spirometry (where available) or peak flow; asthma history, symptoms and medications documented, device use, education
- GP review results; medication review, oversees patient education requirements and completes written Asthma Action Plan for patient
- GP reinforces need for next visit and follow up appointment booked
Visit 2 - Practice Nurse and GP
- Spirometry (where available) or peak flow, review of symptom diary; medication review, follow-up education
- GP review of Asthma Action Plan
- GP reinforces need for next visit and follow up appointment booked
(CCDGP Manual 2007)
RESOURCES
 |
| Printed from http://www.scdgp.org.au/page/Programs/Chronic_Disease_Management_QI/Asthma/ © Sunshine Coast Division of General Practice (SCDGP), Australia |