Exposure to wildfire smoke can be life-threatening for people with respiratory disease. As wildfire smoke blankets large swathes of the eastern United States, Waymark’s pharmacy team is proactively contacting patients with asthma and chronic obstructive pulmonary disease (COPD) in affected areas—merging data on environmental smoke trajectories with data on patient disease severity to ensure patients have access to critical medications, medical equipment, and a clear plan to manage exacerbations resulting from poor air quality.

Primary care providers and pharmacists can help patients with asthma and COPD during periods of heavy smoke exposure in several ways, as recommended by the American Thoracic Society:

• Help patients receive early inhaler refills and nebulizer medication. This helps ensure patients do not run out of these critical medications when they need them. For patients with severe respiratory disease or young children, nebulizers can be an important delivery method for asthma medications when wildfire smoke makes symptoms worse.  
• Access nebulizer equipment and instructions. In addition to medications, we are helping patients in Virginia receive nebulizer machines and masks if they do not already have them. We are also offering guidance on how to properly use nebulizer equipment to get the most benefit during smoke exposure. The American Lung Association has an online video that can help.
• Review and update asthma action plans. Providers and pharmacists can use a template provided by the CDC to help patients develop a plan to manage their asthma during periods of prolonged smoke exposure. Our pharmacy team is proactively reviewing patients’ asthma action plans, and working with primary care providers to make any necessary updates based on the patient’s current condition, risk factors, and recent updates to treatment guidelines. An updated plan can help guide patients on how to respond if wildfire smoke triggers or worsens their symptoms. It’s important to note that guidelines for asthma significantly changed in 2022; providers are recommended to no longer prescribe only short-acting beta-agonist inhalers (like albuterol) alone without other medications. This change was a major shift in practice recommendations, and it often takes time and dedicated education to help providers update their patients’ medication regimens—a challenge our Virginia-based pharmacy team proactively helps with as they outreach primary care providers of our patients.
• Limit smoke exposure. We are educating patients with asthma and COPD on important steps they can take to reduce health risks from wildfire smoke, including staying indoors as much as possible, using an air purifier with HEPA filter, using an N-95 or equivalent mask, and monitoring local air quality reports and health warnings.

The threats of wildfire season are serious for those with underlying respiratory disease, but with the right resources and support, their health impacts can be managed. Our goal is to provide patients with asthma, COPD, and other lung diseases the tools and guidance to manage their health—even in the face of environmental hazards like wildfire smoke.