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Asthma Control: Keep it Going

GIP Priority Message: Assess and Monitor Asthma Control

At planned follow-up visits, asthma patients should review their level of asthma control with their healthcare provider based on multiple measures of current impairment and future risk in order to guide clinician decisions to either maintain or adjust therapy.

The treatment goal is asthma control

Asthma control is the degree to which the manifestations of asthma are minimized by therapeutic interventions—that is, the degree to which the goals of therapy are met. Asthma control, like asthma severity, can be broken down into two domains: current impairment and future risk. Impairment is an assessment of the frequency and intensity of symptoms and functional limitations that a patient is experiencing or has recently experienced. Risk is an estimate of the likelihood either of asthma exacerbations or of progressive loss of pulmonary function over time. In general, classify the level of asthma control by the most severe indicator of impairment or risk.

Monitor asthma control and adjust therapy if needed

The level of control achieved in response to treatment, including success of patient adherence to a realistic and goal-oriented treatment plan, dictates whether a treatment regimen can be maintained by the patient, or whether medication must be adjusted, that is, stepped up if necessary (by increasing the dose, number of medications, and frequency) or stepped down (decreased) if possible. If there are difficulties achieving or maintaining control, consider referral to an asthma specialist for consultation or co-management.

Educate patients on how to recognize inadequate asthma control

Teach and reinforce self-monitoring techniques (either symptom or peak flow monitoring) to enable patients to assess their level of asthma control and to recognize signs of worsening asthma. Peak flow monitoring may be particularly helpful for patients who have difficulty perceiving symptoms, a history of severe exacerbations, or moderate or severe asthma.

Last Updated January 2013