Asthma Management Guidelines - Recommendations,Assessing Asthma Severity

4th Pediatric Infectious Diseases Conference

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ASTHMA IN CHILDREN

Dr C.T.Deshmukh
Professor of Pediatrics, K.E.M Hospital

Asthma Management Guidelines

Continued...

Asthma management guidelines

Various expert committees and global expert panels have reviewed scientific literature over the past many years and have recommended the stepwise management of asthma according to asthma severity. Nearly all the national asthma programs have been following these guidelines. This definite and practical approach has been used world wide with both the patient and doctor satisfaction.

Among the few recommendations are:

Stepwise approach to using medications and early use of anti-inflammatory medication especially in persistent asthma to gain and maintain control of asthma.

Classifications of asthma severity linked to treatment alternatives.

Prevention of asthma and its risk factors by reducing exposures to environmental allergens and secondhand tobacco smoke helps in optimal asthma control and reducing the dose of medications.

Identifying specific allergens for each patient by detail history and allergy testing, and recommendations for reducing exposures to these allergens

Emphasis on teaching asthma self-management and prevention risk factors to patients

Treatment according to patient's cultural, ethnic and economic factors

Objective measurement to be recommended wherever possible (PEFR meter)

Assessing asthma severity

First step in the patients stepwise therapy is assess the patients disease severity. This is done by evaluating the symptoms, history including financial history, current treatment/medications and the response, clinical examination and when possible objective measurement of lung function to establish base line and assess severity. It is recommended that spirometry, which measures lung function, be used in an initial diagnostic work-up.

According to the Guidelines, there are six goals for the effective management of asthma:

Prevent chronic and troublesome symptoms

Maintain (near) 'normal' breathing

Maintain normal activity levels, including exercise

Prevent recurrent asthma flare-ups, and minimize the need for emergency room visits or hospitalizations

Provide optimal medication therapy with no or minimal adverse effects

Meet 'patients and families' expectations of satisfactory asthma care

By working with their doctor to manage their asthma, asthmatics should be able to participate in normal daily activities.

Next : Asthma Investigations

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