Asthma Control Needs to Be Assessed During Each Physician Visit

The National Heart, Lung, and Blood Institute (NHLBI) had originally established guidelines about the diagnosis and management of asthma, and these recent recommendations build upon those original guidelines. It is important for doctors to constantly monitor their patients’ control over his or her asthma because symptoms associated with asthma can change over time. The original NHLBI guidelines already included measuring asthma so that physicians can correctly classify a patient’s asthma severity before treatment begins, but the new practice parameter recommends making asthma management decisions on an ongoing basis, measuring asthma each visit to more accurately determine the patient’s level of control over asthma.

"Asthma is a chronic disease and needs to be continually reassessed," said James T. Li, MD, FAAAAI, and lead author of the new practice parameter. "Every doctor or clinic visit should consist of a detailed assessment to determine if the patient's asthma is or is not under control. People with asthma should not be satisfied with less than well controlled or completely controlled asthma…

"Asthma is not a static disease, and each patient reacts differently to medication, their environment, triggers and changing allergens that affect their asthma symptoms. Assessing these changes requires strong communication between the doctor and patient on an ongoing basis to determine whether changes are needed in medication - either an increase or a decrease."

According to Attaining Optimal Asthma Control: A Practice Parameter, a patient’s asthma control should be assessed at every clinic or physician visit and assessment needs to be individualized because each patient reacts differently to medication. Based on the level of asthma control, asthma management decisions can be more appropriately determined, according to the parameter. If asthma is completely or well-controlled, patients may be able to reduce the amount of medicine they take and decrease their level of therapy while uncontrolled asthma requires a boost in therapy, which may include increased medication use and more frequent visits to the doctor.

The new practice parameter asserts that well or complete controlled asthma control is not only possible, but that asthma sufferers should expect it. The parameter defines complete asthma control as full activity of exercise, no asthma symptoms during the day or at night, no need for “as needed” Albuterol, no missed school or work, and normal lung function.