Asthma Audit Form 2008

A0d823

Description

Blue Cross and Blue Shield of Minnesota R e cog nizing Excellence 2008 Pediatric Asthma Management Audit Form Pay-for-performance program Last updated: 11/17/08 Blue Cross and Blue Shield of Minnesota is a licensee of the Blue Cross and Blue Shield Association 1 2008 Recognizing Excellence (RE) Medical Record Audit Form Numerator Tally PEDIATRIC ASTHMA MANAGEMENT RE criteria met? 1Yes 1No Date of Review: ____/____/___ Reviewer: _______________________ Specialty: Pediatrics Clinic site: ______________________ Clinician ID: ______________ Clinic System:____ _______________ BCBS Member ? 1Yes 1No Clinic Sample ID#: _________ Instructions :Review only the charts that meet the verified inclusion criteria referenced in the criteria summary table (diagnosis of asthma, between ages of 5-18 years, level of asthma severity documented, at least two years of clinic records and dates of service going back 2 years from Dec. 31, 2008). Missing information is considered a NO. Retain this audit tool with your Recognizing Excellence records for reference and validation. Verify Inclusion Criteria: 1. Is the patient between the ages of 5 and 18 as of Dec. 31, 2008 (Date of birth between Dec. 31, 1990 and Dec. 31, 2003)? 1 Yes 1 No If yes, proceed with next question. If no, do not ...

Informations

• Publié par: Thawyag
• Nombre de lectures: 19
• Langue: English

Extrait

1

B l u e

C r o s s

a n d

B l u e

S h i e l d

o f

M in n e s o t a

R e cog nizing

E x c e l l e n c e

2008

Pediatric Asthma Management

Audit

F

o

rm

P

ay-for

-performance

progr

am

Last updated: 11/17/08

Blue

Cross

and

Blue

Shield

of

Minnesota

is

a

licensee

of

the

Blue

Cross

and

Blue

Shield

Association

2

2008 Recognizing Excellence (RE) Medical Record Audit Form

PEDIATRIC ASTHMA MANAGEMENT

Date of Review: ____/____/___

Reviewer: _______________________

Specialty:

Pediatrics

Clinic site: ______________________

Clinician ID: ______________

Clinic System:____ _______________

BCBS Member ?

1

Yes

1

No

Clinic Sample ID#: _________

Instructions :

Review only the charts that meet the verified inclusion criteria referenced in the criteria summary table

(diagnosis of asthma, between ages of 5-18 years, level of asthma severity documented, at least two years of clinic

records and dates of service going back 2 years from Dec. 31, 2008).

Missing information is considered a NO.

Retain this audit tool with your Recognizing Excellence records for reference and validation.

Assess optimal management of the patient with asthma based on the following measures:

1. Is the patient’s asthma severity level documented (see NAEPP guideline for definitions.

NAEPP guidelines can be found

at the following website:

http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm

)?

1

Yes,

complete question 2.

1

No,

stop asthma audit, include this record in the denominator.

2. Is the patient’s asthma severity level documented as

Intermittent

and is it documented that the patient is on a short-

acting Beta

2

Agonist

as needed

(Albuterol, Levalbuterol or Pirbuterol)?

1

Yes,

stop asthma audit, include this record in the numerator and denominator.

1

No, the patient’s asthma severity level is documented as intermittent, but the patient is not on a short-acting

Beta

2

Agonist as needed.

Stop asthma audit, include this record in the denominator.

1

No, patient’s asthma severity level is documented as persistent,

complete question 3.

3.

Is the patient’s asthma severity level documented as

Persistent

and is the patient between the

ages of 5 – 11

as of Dec.

31, 2008 (Date of birth between Dec. 31, 1997 and Dec. 31, 2003)?

1

Yes,

complete question 4

.

1

No, the patient is between the ages of 12 – 18 as of Dec. 31, 2008 (Date of birth between Dec. 31, 1990 and Dec. 31,

1996),

complete question 5.

Numerator Tally

RE criteria met?

1

Yes

1

No

Verify Inclusion Criteria:

1. Is the patient between the ages of 5 and 18 as of Dec. 31, 2008 (Date of birth between Dec. 31, 1990 and Dec. 31, 2003)?

1

Yes

1

No

If yes, proceed with next question.

If no, do not include this record in the denominator. Pull a new medical record from eligible population identified.

2. Is the diagnosis of asthma documented?

1

Yes

1

No

If yes, proceed with next question.

If no, do not include this record in the denominator. Pull a new medical record from eligible population identified.

3. Is this an established patient? (Do you have at least two years of clinic records for this patient?)

1

Yes

1

No

If yes, proceed with next question.

If no, do not include this record in the denominator. Pull a new medical record from eligible population identified.

3

4. Is the

5 – 11

year old

patient being treated with one of the following steps (options 1-7) based on severity level and

control?

1

Yes,

check option boxes and then stop asthma audit, include this record in the numerator and

denominator.

1

No, (option 8)

stop asthma audit, include this record in the denominator.

Mild Persistent

Moderate Persistent

Severe Persistent

1

Option 1 (Preferred)

1

Option 1 (Preferred)

1

Option 1 (Preferred)

Step 2:

Low-Dose ICS

Step 3:

Low-Dose ICS AND LABA

OR

Low-Dose ICS/LABA

Step 5:

High-Dose ICS AND LABA AND

Consultation with Asthma Specialist

OR

High-Dose ICS/LABA AND Consultation

with Asthma Specialist

Choose one from below:

Choose one from each section A + B

OR

choose one from section C

Choose one from each section A + B + D

OR

one from each section C + D

1

Beclomethasone (QVAR)

Section A: Low-Dose ICS

Section A: High-Dose ICS

1

Budesonide DPI (Pulmicort)

1

Beclomethasone (QVAR)

1

Beclomethasone (QVAR)

1

Flunisolide (Aerobid,

Aerobid-M)

1

Budesonide DPI (Pulmicort)

1

Budesonide DPI (Pulmicort)

1

Fluticasone MDI (Flovent)

1

Flunisolide (Aerobid, Aerobid-M)

1

Flunisolide (Aerobid, Aerobid-M)

1

Fluticasone DPI (Flovent

Rotadisk)

1

Fluticasone MDI (Flovent)

1

Fluticasone MDI (Flovent)

1

Triamcinolone Acetonide

(Azmacort)

1

Fluticasone DPI (Flovent Rotadisk)

1

Fluticasone DPI (Flovent Rotadisk)

1

Mometasone (Asmanex)

1

Triamcinolone Acetonide (Azmacort)

1

Triamcinolone Acetonide (Azmacort)

1

Mometasone (Asmanex)

1

Mometasone (Asmanex)

Section B: LABA

Section B: LABA

1

Salmeterol (Serevent)

1

Salmeterol (Serevent)

1

Formoterol Fumarate DPI (Foradil)

1

Formoterol Fumarate DPI (Foradil)

Section C:

Low-Dose ICS/LABA

Section C:

High-Dose ICS/LABA

1

Fluticasone Propionate/Salmeterol

(Advair)

1

Fluticasone Propionate/Salmeterol (Advair)

Section D:

Consult

1

Consultation with Asthma Specialist

Question 4 continued on next page.

4

Mild Persistent

Moderate Persistent

Severe Persistent

1

Option 2 (Alternative)

1

Option 2 (Alternative)

1

Option 2 (Alternative)

Step 2:

Leukotriene Modifier

Step 3:

Low-Dose ICS AND Leukotriene

Modifier

Step 5:

High-Dose ICS AND Leukotriene Modifier

AND Consultation with Asthma Specialist

Choose one from below:

Choose one from each section A + B

Choose one from each section A + B + C

1

Montelukast (Singulair)

Section A: Low-Does ICS

Section A: High-Dose ICS

1

Zafirlukast (Accolate)

1

Beclomethasone (QVAR)

1

Beclomethasone (QVAR)

1

Budesonide DPI (Pulmicort)

1

Budesonide DPI (Pulmicort)

1

Flunisolide (Aerobid, Aerobid-M)

1

Flunisolide (Aerobid, Aerobid-M)

1

Fluticasone MDI (Flovent)

1

Fluticasone MDI (Flovent)

1

Fluticasone DPI (Flovent Rotadisk)

1

Fluticasone DPI (Flovent Rotadisk)

1

Triamcinolone Acetonide (Azmacort)

1

Triamcinolone Acetonide (Azmacort)

1

Mometasone (Asmanex)

1

Mometasone (Asmanex)

Section B:

Leukotriene Modifier

Section B:

Leukotriene Modifier

1

Montelukast (Singulair)

1

Montelukast (Singulair)

1

Zafirlukast (Accolate)

1

Zafirlukast (Accolate)

Section C: Consult

1

Consultation with Asthma Specialis

t

1

Option 3 (Alternative)

1

Option 3 (Alternative)

1

Option 3 (Alternative)

Step 2:

Cromolyn or Nedocromil

Step 3:

Low-Dose ICS AND Theophylline

Step 5:

High-Dose ICS AND Theophylline AND

Consultation with Asthma Specialist

Choose one from below:

Choose one from each section A + B

Choose one from each section A + B + C

1

Cromolyn (Intal)

Section A: Low-Dose ICS

Section A: High-Dose ICS

1

Nedocromil (Tilade)

1

Beclomethasone (QVAR)

1

Beclomethasone (QVAR)

1

Budesonide DPI (Pulmicort)

1

Budesonide DPI (Pulmicort)

1

Flunisolide (Aerobid, Aerobid-M)

1

Flunisolide (Aerobid, Aerobid-M)

1

Fluticasone MDI (Flovent)

1

Fluticasone MDI (Flovent)

1

Fluticasone DPI (Flovent Rotadisk)

1

Fluticasone DPI (Flovent Rotadisk)

1

Triamcinolone Acetonide (Azmacort)

1

Triamcinolone Acetonide (Azmacort)

1

Mometasone (Asmanex)

1

Mometasone (Asmanex)

Section B: Theophylline

Section B:

Theophylline

1

Methylxanthines (Theophylline)

1

Methylxanthines (Theophylline)

Section C: Consult

1

Consultation with Asthma Specialist

Question 4 continued on next page.

5

Mild Persistent

Moderate Persistent

Severe Persistent

1

Option 4 (Alternative)

1

Option 4 (Alternative)

1

Option 4 (Preferred)

Step 2:

Theophylline

Step 3:

Medium-Dose ICS

Step 6:

High-Dose ICS AND LABA AND Oral

Systemic Corticosteroid AND Consultation

with Asthma Specialist

OR

High-Dose ICS/LABA AND Oral Systemic

Corticosteroid AND Consultation with

Asthma Specialist

Choose one from below:

Choose one from below:

Choose one from each section A + B + D + E

OR

one from each section C + D + E

1

Methylxanthines

(Theophylline)

1

Beclomethasone (QVAR)

Section A: High-Dose ICS

1

Budesonide DPI (Pulmicort)

1

Beclomethasone (QVAR)

1

Flunisolide (Aerobid, Aerobid-M)

1

Budesonide DPI (Pulmicort)

1

Fluticasone MDI (Flovent)

1

Flunisolide (Aerobid, Aerobid-M)

1

Fluticasone DPI (Flovent Rotadisk)

1

Fluticasone MDI (Flovent)

1

Triamcinolone Acetonide (Azmacort)

1

Fluticasone DPI (Flovent Rotadisk)

1

Mometasone (Asmanex)

1

Triamcinolone Acetonide (Azmacort)

1

Mometasone (Asmanex)

Section B: One or more LABA

1

Salmeterol (Serevent)

1

Formoterol Fumarate DPI (Foradil)

Section C:

High-Dose ICS/LABA

1

Fluticasone Propionate/Salmeterol (Advair)

Section D: Oral Systemic Corticosteroid

1

Methylprednisolone

1

Prednisolone

1

Prednisone

Section E: Consult

1

Consultation with Asthma Specialist

Question 4 continued on next page.

6

Mild Persistent

Moderate Persistent

Severe Persistent

1

Option 5 (Alternative)

1

Option 5 (Preferred)

1

Option 5 (Alternative)

Step 1:

(If mild persistent patient has

been well controlled for 3

months, may step down to

this step)

Short-acting

Beta

2

Agonist

as

needed

Step 4:

Medium-Dose ICS AND LABA AND

Consultation with Asthma Specialist

OR

Medium- Dose ICS/LABA AND

Consultation with Asthma Specialist

Step 6:

High-Dose ICS AND Theophylline AND Oral

Systemic Corticosteroid AND Consultation

with Asthma Specialist

Choose one from below:

Choose one from each section

A + B + D

OR

one from each section C + D

Choose one from each section A + B + C + D

1

Albuterol (ProAir HFA,

Proventil HFA and Ventolin

HFA, AccuNeb)

Section A: Medium-Dose ICS

Section A: High-Dose ICS

1

Levalbuterol (Xopenex HFA,

Xopenex)

1

Beclomethasone (QVAR)

1

Beclomethasone (QVAR)

1

Pirbuterol (Maxair)

1

Budesonide DPI (Pulmicort)

1

Budesonide DPI (Pulmicort)

1

Flunisolide (Aerobid, Aerobid-M)

1

Flunisolide (Aerobid, Aerobid-M)

1

Fluticasone MDI (Flovent)

1

Fluticasone MDI (Flovent)

1

Fluticasone DPI (Flovent Rotadisk)

1

Fluticasone DPI (Flovent Rotadisk)

1

Triamcinolone Acetonide (Azmacort)

1

Triamcinolone Acetonide (Azmacort)

1

Mometasone (Asmanex)

1

Mometasone (Asmanex)

Section B:

LABA

Section B: Theophylline

1

Salmeterol (Serevent)

1

Methylxanthines (Theophylline)

1

Formoterol Fumarate DPI (Foradil)

Section C:

Medium-Dose ICS/LABA

Section C: Oral Systemic Corticosteroid

1

Fluticasone Propionate/Salmeterol

(Advair)

1

Methylprednisolone

1

Prednisolone

1

Prednisone

Section D: Consult

Section D: Consult

1

Consultation with Asthma Specialist

1

Consultation with Asthma Specialist

Question 4 continued on next page.

7

Mild Persistent

Moderate Persistent

Severe Persistent

1

Option 6 (Alternative)

1

Option 6 (Alternative)

Step 4:

Medium-Dose ICS AND Leukotriene

Modifier AND Consultation with

Asthma Specialist

Step 6:

High-Dose ICS AND Leukotriene Modifier

AND Oral Systemic Corticosteroid AND

Consultation with Asthma Specialist

Choose one from each section

A + B + C

Choose one from each section A + B + C + D

Section A:

Medium-Dose ICS

Section A: High-Dose ICS

1

Beclomethasone (QVAR)

1

Beclomethasone (QVAR)

1

Budesonide DPI (Pulmicort)

1

Budesonide DPI (Pulmicort)

1

Flunisolide (Aerobid, Aerobid-M)

1

Flunisolide (Aerobid, Aerobid-M)

1

Fluticasone MDI (Flovent)

1

Fluticasone MDI (Flovent)

1

Fluticasone DPI (Flovent Rotadisk)

1

Fluticasone DPI (Flovent Rotadisk)

1

Triamcinolone Acetonide (Azmacort)

1

Triamcinolone Acetonide (Azmacort)

1

Mometasone (Asmanex)

1

Mometasone (Asmanex)

Section B: Leukotriene Modifier

Section B: Leukotriene Modifier

1

Montelukast (Singulair)

1

Montelukast (Singulair)

1

Zafirlukast (Accolate)

1

Zafirlukast (Accolate)

Section C: Consult

Section C:

Oral Systemic Corticosteroid

1

Consultation with Asthma Specialist

1

Methylprednisolone

1

Prednisolone

1

Prednisone

Section D: Consult

1

Consultation with Asthma Specialist

1

Option 7 (Alternative)

Step 4:

Medium-Dose ICS AND Theophylline

AND Consultation with Asthma

Specialist

Choose one from each section

A + B + C

Section A:

Medium-Dose ICS

1

Beclomethasone (QVAR)

1

Budesonide DPI (Pulmicort)

1

Flunisolide (Aerobid, Aerobid-M)

1

Fluticasone MDI (Flovent)

1

Fluticasone DPI (Flovent Rotadisk)

1

Triamcinolone Acetonide (Azmacort)

1

Mometasone (Asmanex)

Section B: Theophylline

1

Methylxanthines (Theophylline)

Section C: Consult

1

Consultation with Asthma Specialist

Question 4 continued on next page.

8

Mild Persistent

Moderate Persistent

Severe Persistent

1

Option 8

1

Option 8

1

Option 8

None of the above

None of the above

None of the above

5.

Is the

12 – 18

year old

patient being treated with one of the following steps (options 1-7) based on severity level and

control?

1

Yes,

check option boxes and then stop asthma audit, include this record in the numerator and denominator.

1

No (option 8),

stop asthma audit, include this record in the denominator.

Mild Persistent

Moderate Persistent

Severe Persistent

1

Option 1 (Preferred)

1

Option 1 (Preferred)

1

Option 1 (Preferred)

Step 2:

Low-Dose ICS

Step 3:

Low-Dose ICS AND LABA

OR

Low-Dose ICS/LABA

Step 5:

High-Dose ICS AND LABA AND

Consultation with Asthma Specialist

OR

High-Dose ICS/LABA AND Consultation

with Asthma Specialist

Choose one from below:

Choose one from each section A + B

OR

one from Section C

Choose one from each section A + B + D

OR

one from each section C + D

1

Beclomethasone (QVAR)

Section A: Low-Dose ICS

Section A: High-Dose ICS

1

Budesonide DPI (Pulmicort)

1

Beclomethasone (QVAR)

1

Beclomethasone (QVAR)

1

Flunisolide (Aerobid,

Aerobid-M)

1

Budesonide DPI (Pulmicort)

1

Budesonide DPI (Pulmicort)

1

F

luticasone MDI (Flovent)

1

Flunisolide (Aerobid, Aerobid-M)

1

Flunisolide (Aerobid, Aerobid-M)

1

Fluticasone DPI (Flovent

Rotadisk)

1

Fluticasone MDI (Flovent)

1

Fluticasone MDI (Flovent)

1

Triamcinolone Acetonide

(Azmacort)

1

Fluticasone DPI (Flovent Rotadisk)

1

Fluticasone DPI (Flovent Rotadisk)

1

Mometasone (Asmanex)

1

Triamcinolone Acetonide (Azmacort)

1

Triamcinolone Acetonide (Azmacort)

1

Mometasone (Asmanex)

1

Mometasone (Asmanex)

Section B: LABA

Section B: One or more LABA

1

Salmeterol (Serevent)

1

Salmeterol (Serevent)

1

Formoterol Fumarate DPI (Foradil)

1

Formoterol Fumarate DPI (Foradil)

Section C:

Low-Dose ICS/LABA

Section C:

High-Dose ICS/LABA

1

Fluticasone Propionate/Salmeterol

(Advair)

1

Fluticasone Propionate/Salmeterol (Advair)

1

Budesonide/formoterol (Symbicort)

1

Budesonide/formoterol (Symbicort)

Section D: Consult

1

Consultation with Asthma Specialist

Question 5 continued on next page.

9

Mild Persistent

Moderate Persistent

Severe Persistent

1

Option 2 (Alternative)

1

Option 2

(Alternative)

1

Option 2

(Alternative)

Step 2:

Leukotriene Modifier

Step 3:

Low-Dose ICS AND Leukotriene

Modifier

Step 5:

High-Dose ICS AND LABA AND

Leukotriene Modifier

AND Consultation

with Asthma Specialist

OR

High-Dose ICS/LABA AND

Leukotriene

Modifier

AND Consultation with Asthma

Specialist

Choose one from below:

Choose one from each section A +B

Choose one from each section A + B + D + E

OR

one from each section C + D + E

Section A: Low-Does ICS

Section A: High-Dose ICS

1

Montelukast (Singulair)

1

Beclomethasone (QVAR)

1

Beclomethasone (QVAR)

1

Zafirlukast (Accolate)

1

Budesonide DPI (Pulmicort)

1

Budesonide DPI (Pulmicort)

1

Zileuton (Zyflo)

1

Flunisolide (Aerobid, Aerobid-M)

1

Flunisolide (Aerobid, Aerobid-M)

1

Fluticasone MDI (Flovent)

1

Fluticasone MDI (Flovent)

1

Fluticasone DPI (Flovent Rotadisk)

1

Fluticasone DPI (Flovent Rotadisk)

1

Triamcinolone Acetonide (Azmacort)

1

Triamcinolone Acetonide (Azmacort)

1

Mometasone (Asmanex)

1

Mometasone (Asmanex)

Section B:

Leukotriene Modifier

Section B: LABA

1

Montelukast (Singulair)

1

Salmeterol (Serevent)

1

Zafirlukast (Accolate)

1

Formoterol Fumarate DPI (Foradil)

1

Zileuton (Zyflo)

Section C:

High-Dose ICS/LABA

1

Fluticasone Propionate/Salmeterol (Advair)

1

Budesonide/formoterol (Symbicort)

Section D:

Leukotriene Modifier

1

Montelukast (Singulair)

1

Zafirlukast (Accolate)

1

Zileuton (Zyflo)

Section E: Consult

1

Consultation with Asthma Specialist

Question 5 continued on next page.

10

Mild Persistent

Moderate Persistent

Severe Persistent

1

Option 3 (Alternative)

1

Option 3 (Alternative)

1

Option 3 (Preferred)

Step 2:

Cromolyn/Nedocromil

Step 3:

Low-Dose ICS AND Theophylline

Step 6:

High-Dose ICS AND LABA AND Oral

Systemic Corticosteroid AND Consultation

with Asthma Specialist

OR

High-Dose ICS/LABA AND Oral Systemic

Corticosteroid AND Consultation with

Asthma Specialist

Choose one from below:

Choose one from each section A + B

Choose one from each section

A + B + D + E

OR

one from each section C + D + E

1

Cromolyn (Intal)

Section A: Low-Dose ICS

Section A: High-Dose ICS

1

Nedocromil (Tilade)

1

Beclomethasone (QVAR)

1

Beclomethasone (QVAR)

1

Budesonide DPI (Pulmicort)

1

Budesonide DPI (Pulmicort)

1

Flunisolide (Aerobid, Aerobid-M)

1

Flunisolide (Aerobid, Aerobid-M)

1

Fluticasone MDI (Flovent)

1

Fluticasone MDI (Flovent)

1

Fluticasone DPI (Flovent Rotadisk)

1

Fluticasone DPI (Flovent Rotadisk)

1

Triamcinolone Acetonide (Azmacort)

1

Triamcinolone Acetonide (Azmacort)

1

Mometasone (Asmanex)

1

Mometasone (Asmanex)

Section B: Theophylline

Section B: LABA

1

Methylxanthines (Theophylline)

1

Salmeterol (Serevent)

1

Formoterol Fumarate DPI (Foradil)

Section C:

High-Dose ICS/LABA

1

Fluticasone Propionate/Salmeterol (Advair)

1

Budesonide/formoterol (Symbicort)

Section D:

Oral Systemic Corticosteroid

1

Methylprednisolone

1

Prednisolone

1

Prednisone

Section E: Consult

1

Consultation with Asthma Specialist

Question 5 continued on next page.

11

Mild Persistent

Moderate Persistent

Severe Persistent

1

Option 4 (Alternative)

1

Option 4 (Alternative)

1

Option 4 (Alternative)

Step 2:

Theophylline

Step 3:

Medium-Dose ICS

Step 6:

High-Dose ICS AND LABA AND Oral

Systemic Corticosteroid AND Leukotriene

Modifier AND Consultation with Asthma

Specialist

OR

High-Dose ICS/LABA AND Oral Systemic

Corticosteroid AND Leukotriene Modifier

AND Consultation with Asthma Specialist

Choose one from below:

Choose one from below:

Choose one from each section

A + B + D + E + F

OR

one from each section C + D + E + F

1

Methylxanthines

(Theophylline)

1

Beclomethasone (QVAR)

Section A: High-Dose ICS

1

Budesonide DPI (Pulmicort)

1

Beclomethasone (QVAR)

1

Flunisolide (Aerobid, Aerobid-M)

1

Budesonide DPI (Pulmicort)

1

Fluticasone MDI (Flovent)

1

Flunisolide (Aerobid, Aerobid-M)

1

Fluticasone DPI (Flovent Rotadisk)

1

Fluticasone MDI (Flovent)

1

Triamcinolone Acetonide (Azmacort)

1

Fluticasone DPI (Flovent Rotadisk)

1

Mometasone (Asmanex)

1

Triamcinolone Acetonide (Azmacort)

1

Mometasone (Asmanex)

Section B: LABA

1

Salmeterol (Serevent)

1

Formoterol Fumarate DPI (Foradil)

Section C:

High-Dose ICS/LABA

1

Fluticasone Propionate/Salmeterol (Advair)

1

Budesonide/formoterol (Symbicort)

Section D:

Oral Systemic Corticosteroid

1

Methylprednisolone

1

Prednisolone

1

Prednisone

Section E:

Leukotriene Modifier

1

Montelukast (Singulair)

1

Zafirlukast (Accolate)

1

Zileuton (Zyflo)

Section F: Consult

1

Consultation with Asthma Specialist

Question 5 continued on next page.