Table 2:

Recommended Sequential Approach to Improve Recognition and Management of Work-Related Asthma in Primary Care Settings

Recommendation 1a
IF
Reason for visit = Asthma (ICD-9 493; ICD-10: J45 ) that began within the last two years
OR
Patient had one or more emergency department or acute clinic/hospital visits for asthma over the past two years
THEN:	Ask:
	1) Do/did your asthma symptoms start at your current/recent workplace?
	2) Do/did your asthma symptoms worsen at work?
	3) Are asthma symptoms different (e.g. better) on days off work and/or holidays?
Recommendation 1b
IF
Patient responds positively to any of the 3 screening questions
THEN:	Clarify the diagnosis of asthma with acceptable and repeatable spirometry testing that meets ATS guidelines for quality
Recommendation 1c
IF
Patient responds “yes” to any of the 3 screening questions
AND
Patient has asthma
THEN:	Provide WRA tools to the clinician and patient
	AND:
	Document the discussion regarding the patient’s work and respiratory symptoms in EHR