Asthma is a very serious condition, affecting an estimated 262 million people in 2019 and causing 455 000 deaths, but it is also often underdiagnosed and undertreated.
Asthma does not have a cure, but the symptoms can be controlled. Asthma triggers change in prevalence over the course of the year (seasonal triggers, colds and flu outbreaks, etc.) so it is important to work with a doctor to track the symptoms and signs, and adjust the treatment plans accordingly.
Importance of asthma control
Asthma control is defined as the prevention of asthma symptoms. It is vital for any asthma patient to track their condition. With diligent and constant monitoring as a part of asthma control, it is possible to make changes before symptoms of the condition are exacerbated. This also would prevent unnecessary visits to the hospital, improving health outcomes in the long run.
These are the points that need to be looked at to assess the level of asthma control of the patient:
- the frequency of daytime symptoms (coughing, wheezing, tightness of the chest, shortness of breath)
- the frequency of nighttime symptoms (waking up at night due to symptoms such as coughing, wheezing, tightness of the chest, shortness of breath)
- how often the quick-relief or rescue inhaler use is
- the level of difficulty performing normal activities
If the patient has symptoms or uses their inhaler more than twice a week, wakes up with symptoms more than twice a month, or refills their inhaler prescription more than twice a year; this may point to their asthma not being controlled well.
When the condition is controlled well, the risk of having an exacerbation and having to visit the hospital is significantly reduced.
The role of asthma control in asthma management
Assessing the level of control makes it possible for medications to be adjusted accordingly and makes the process of creating an asthma action plan easier.
With daily vigilance in assessing the symptoms, the action plan can be quickly consulted and control measures can be adjusted. In order to do this, first, asthma control needs to be assessed and monitored. This leads to reviewing medication technique and adherence, an assessment of the side effects and a review of environmental control. Then, the medication is either maintained, stepped up, or stepped down. Lastly, the asthma action plan is reviewed, revised as needed and the next follow-up appointment is scheduled.
To ensure all of the steps of asthma management are properly executed, the symptoms and triggers should be constantly tracked and logged, and home spirometry should be used to monitor lung values.
- Global Burden of Disease - GBD Cause and Risk Summaries, Lancet, 2020.
- Asthma, World Health Organization, 2022.
- Asthma, Mayo Clinic, 2022.
- Assess and Monitor Your Asthma Control, American Lung Association, 2020.
- Asthma Care Quick Reference: Diagnosing and Managing Asthma, National Heart, Lung and Blood Institute, 2012.