THE FOUR COMPONENTS OF ASTHMA MANAGEMENT

The Expert Panel Reports presenting clinical practice guidelines for the diagnosis and management of asthma have organized recommendations for asthma care around four components considered essential to effective asthma management.

Measures of assessment and monitoring asthma

This includes objective tests, physical examination, patient history and patient report, to diagnose and assess the characteristics and severity of asthma and to monitor whether asthma control is achieved and maintained.

Patient Education for a partnership in asthma care

Patient education is an essential component of successful asthma management.  It should begin at the time of diagnosis and be integrated into every step of medical care. Asthma education programs have led to improved patient outcomes, including reduced hospitalizations and emergency room visits, fewer asthma symptoms and physician visits, and improvement in asthma management skills. However, the performance and adequacy of education is not easily assessed through medical record review. Therefore, the review and the indicators that follow will not focus on the patient-education component of care.

Control of environmental factors and co morbid conditions that affect asthma

Pharmacologic therapy for asthma

Asthma therapy has several components: patient education, control of factors contributing to severity, and pharmacological therapy, as well as the use of objective measures to assess the severity of disease and monitor the course of therapy.

Corticosteroids

Corticosteroids are the most potent and the most effective anti-inflammatory medication currently available. Anti-inflammatory medications are proven to improve lung function (i.e. FEV1, airway hyperresponsiveness) and to decrease symptoms, exacerbation frequency, and the need for rescue inhalers. 
Inhaled forms are used for long-term control and are now the mainstay of therapy, Oral or systemic corticosteroids are often used to obtain prompt control of the disease when beginning long-term therapy.
Inhaled corticosteroids, at currently approved doses, are safe and effective for the treatment of asthma and are being utilized more frequently as primary therapy.

In any patient requiring chronic treatment with oral corticosteroids (i.e., exceeding one month in duration), a trial of inhaled corticosteroids should be attempted in an effort to reduce or eliminate oral steroids.
High doses of inhaled steroids are used if conventional doses fail to permit oral steroid tapering. Pulmonary functions (PEF or FEV1) are monitored during tapering.

Prolonged daily use of oral corticosteroids is reserved for patients with severe asthma despite use of high-dose inhaled corticosteroids. In patients on long-term oral corticosteroids, pulmonary function tests should be used to objectively assess efficacy.

Click the banner below to know:

Next page