Dr. Bukstein - Encourage your patient to use cell phones to make videos of their sleeping to look for OSA, take pictures of their rashes. We call this “rash-selfie” at CCF.
“Use cell phones: rashes, VCD, sleep problems.” Couldn’t agree more. Smart phones have changed our practice. From Laryngotracheomalacia in a NICU graduate to eczema vs urticaria, photos/video/audio on cell phones have changed allergy practice.
Dr Bukstein practices A/I in inner city Milwaukee: “Asthma is a disease of poor communication rather than increased inflammation.”
"Rules of Two": Generally, a patient should be on a daily controller medication if he or she: have asthma symptoms/attacks more than twice a week, wakes up due to asthma symptoms more than twice a month.
So much to cover, so little time. How can docs discuss shared decision making, anticipatory guidance, AND patient concerns during a time limited office visit? Need to buy in, use checklists, existing tools to assist documentation. Communication & organization are key.
Go to patient advocacy websites so you are aware of what your patients are reading about their disease online.
@AllergyKidsDoc Plenary speaker Don Bukstein: “Spend time visiting patient centered websites & advocacy organizations. It’s important to understand the information our patients are receiving outside the office.” This approach has changed my entire career!
@mrathkopf Dr Bukstein's blueprint for shared decision making in a 30 min patient visit and team based care: https://twitter.com/mrathkopf/status/1064198773629378560
Shared decision making is not a 'one and done' process - evaluate the management decisions along the way.
The @ACAAI has a shared decision making tool for patients to decide about allergen immunotherapy: http://allergytherapy.acaai.org
Dr. Bukstein: most non-adherence is intentional.
This is a Twitter summary from #ACAAI18 meeting based on tweets by the following allergists: @kparksmd @DrAnneEllis @AllergyKidsDoc