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Asthma Guidelines Update
Virginia Taggart, M.P.H., Patricia Noel, Ph.D., and James Kiley, Ph.D.

Chances are that you know people who have asthma. Are they getting the best care possible?

More than 22 million Americans have asthma. Many hospitalizations, urgent visits to the doctor, or school or work days missed due to asthma could be prevented with appropriate care. The National Heart, Lung, and Blood Institute (NHLBI) is committed to finding the best ways to treat asthma, and, ultimately, prevent it from developing. Research results have led to exciting breakthroughs. We now know that asthma can be controlled so that most patients can lead active lives without symptoms, sleep through the night, and have good lung function.

The NHLBI's National Asthma Education and Prevention Program (NAEPP) periodically reviews clinical studies on asthma, considers the weight of the evidence, and translates the findings into guidelines for clinical practice.

The NAEPP recently released the third update of the asthma guidelines, giving doctors easy access to the most up-to-date information and expert advice on managing asthma. Quality asthma care includes four activities: educating patients in self-management skills, monitoring asthma control, reducing exposure to environmental factors that worsen asthma, and administering medications. There is new information about all of these activities. As a patient, what differences might you expect in asthma care?

  • You should receive a written asthma action plan that describes how to control asthma long-term AND how to handle worsening asthma, or attacks.
  • You will need quick relief medication for symptoms. Many patients also need daily long term control medication--the new guidelines conclude that inhaled corticosteroids will benefit most of these patients. Other medications may also be helpful. Doctors and patients need to work together to choose the best medication plan for each patient's circumstances.
  • Your doctor will help identify which allergens or irritants are important for you to avoid. The new guidelines stress that multiple measures are necessary to control exposure to allergens and irritants.
  • You should get regular asthma check-ups to monitor your asthma control. Visits at least every 6 months are recommended because asthma varies from season to season and it can change as you grow older. Monitoring allows your doctor to increase medications if necessary or decrease medications if possible.
  • During doctor visits, you will be asked questions about symptoms, medication use, and occurrence of attacks. You will be given a lung function test. Be sure to ask questions and discuss any concerns about your asthma treatment. This way, you and your doctor can work together on a plan that is best for you.
An important message of the new guidelines is that asthma education shouldn't just happen in the doctor's office. Education and asthma friendly policies throughout the community-- in clinics, schools, workplaces, pharmacies, patient homes, and recreation programs --will help all people with asthma receive the best possible care.

This article was published in the Fall 2007 issue of the ALA Lung Health Magazine.

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