Allegry and Asthma Health - New Asthma Assessment Guidelines Released by ATS/ERS

Six Key Asthma Messages Every Asthmatic and Health Care Provider Should Know

by Rhonda Vosmus, RRT-NPS, AE-C

Asthma is a chronic inflammatory disease of the airways. In the United States, asthma affects more than 22 million people. We have made important gains since the release of the first National Heart, Lung and Blood Institute (NHLBI) asthma management guidelines in 1991.

For example, the number of deaths due to asthma has declined, even in the face of an increasing prevalence of the disease; fewer patients who have asthma report limitations to activities; and an increasing proportion of people who have asthma receive formal education. Hospitalization rates have remained relatively stable over the last decade, with lower rates in some age groups but higher rates among young children 0–4 years of age. There is some indication that improved recognition of asthma among young children contributes to these rates.

However, the burden of avoidable hospitalizations remains. Collectively, people who have asthma have more than 497,000 hospitalizations annually. Furthermore, ethnic and racial disparities in asthma persist, with significant impact on African American and Puerto Rican populations.

Six key asthma messages

The challenge remains to help all people who have asthma, particularly those at high risk, receive quality asthma care. Unfortunately, too many people are still having problems managing their asthma, despite the fact that our national asthma guidelines explain how to keep symptoms under control.

The NHLBI asthma guidelines are evidence-based, best-practice standards for asthma management that were updated in 2007 to help more health care professionals adopt the recommendations in their daily practices. The Guideline Implementation Report (GIP) is included in the guidelines and delivers six key asthma messages for health professionals and patients/families with asthma:

Classify asthma severity: All asthmatics should be tested for the severity of their asthma to determine the type and level of initial therapy needed.
Persistent asthma requires two medications—controller and quick relief: If you have persistent asthma, you should take controller medications on a regular and long-term basis to achieve and maintain control of your asthma symptoms. Inhaled corticosteroids are considered "front line" therapy and consistently and effectively are used to control asthma symptoms. You should also have a quick-relief medication handy.
Monitor signs and symptoms: You and your family should understand how to recognize asthma symptom patterns and/or to measure asthma control using a small, handheld device called a peak flow meter. Peak flow meters can be used by all asthmatics over the age of five.
Identify triggers: Your health care provider should determine your exposure to allergens, irritants, and viruses and provide an effective strategy to reduce exposure to those that make your asthma worse.
A written asthma action plan: Everyone who has asthma should receive a written asthma action plan from their health care provider that includes instructions for daily treatment and how to recognize and handle worsening asthma. The plan will help you know what to do when and also who to call for help.
Regularly scheduled follow-up visits to your health care provider to determine the level of asthma control: Schedule follow-up visits regularly to be sure your asthma is in control and modify the treatment as needed.

Rhonda Vosmus is a Registered Respiratory Therapist and American Association for Respiratory Care (AARC) member from Portland, ME, where she serves as an asthma education specialist at the Maine Medical Center.