The Antenatal Asthma Management Service (AMS) at the John Hunter Hospital, Hunter New England Health, Australia, offers specialised asthma care during pregnancy. The program aims to provide appropriate education to improve women’s knowledge on asthma and pregnancy, optimise asthma treatments and device techniques and empower women to self-manage their asthma during pregnancy.
- All pregnant women are screened for asthma at their first antenatal visit to the hospital
- Women with asthma are informed about the AMS service, and those who are interested will be referred to the AMS team.
- AMS care includes two asthma care consultations. A nurse specialist delivers the first consultation and a respiratory physician delivers the second consultation.
The nurse specialist assesses the woman’s asthma history, asthma knowledge, self-management skills, current medications and usage, device techniques, asthma triggers, current asthma control and presence of any comorbid conditions using a structured asthma assessment form. The nurse specialist provides education addressing the gaps identified in the assessment, discussing the following topics:
- An overview of the importance of good asthma control during pregnancy
- Medication use and the importance of medication adherence during pregnancy
- Good inhaler techniques
- Asthma trigger avoidance
- Develop and/or review of an asthma self-management plan
- If needed, brief behavioural advice on comorbidities such as tobacco smoking, reflux, obstructive sleep apnoea and chronic rhinitis are also provided.
The respiratory physician reviews the asthma assessment form and reinforces the education provided by the nurse specialist. If prescription medications are required (new medication or changes to the current medication), this is coordinated by the physician.
All participants are offered written asthma education materials:
- Asthma Australia’s asthma and pregnancy brochure
- Asthma basic facts brochure
- Asthma Australia’s Kiss My Asthma App
Follow-up appointments are scheduled if needed. Otherwise, participants are discharged to their GP for continuing support.
Telehealth model of care
During COVID-19, the asthma care at AMS was moved to a telehealth model of care, with all the above services provided using a virtual care platform, myVirtualCare.