Spring is the time to review aspects of good asthma control
6/2/2016 by Joy Fladager Muth, APRN, CNP
The Asthma and Allergy Foundation of America (AAFA) declares May to be "National Asthma and Allergy Awareness Month." According to the Centers for Disease Control (CDC) one in fourteen people have asthma. As of 2013, the CDC reported:
- Twenty-four million Americans have asthma and 6.3 million are under the age of 18 years.
- One in 10 school-aged children have asthma.
- Asthma is the third-leading cause of hospital stays in children.
- Boys are more likely to have asthma than girls, but women are more likely to have asthma than men.
- Ten Americans die from asthma each day.
- Adults are seven times more likely than children to die from asthma.
- The asthma death rate was highest for people 65 and or older.
Spring is a peak season for asthma and allergy sufferers and an important time to review aspects of good asthma control. No matter the severity level, these factors are indicators that asthma is well controlled for adults and children with asthma:
- No chronic or persistent troublesome symptoms, such as coughing or shortness of breath.
- Minimal requirement of quick-relief medicines: less than twice a week during the day (outside of premedication for triggers; i.e., exercise) or twice a month at night.
- Maintenance of best lung function (often monitored with spirometry annually or more often).
- Maintenance of normal activity level (can exercise, play sports, attend school or work, etc).
- Sleeping through the night.
- One or less asthma attacks per year that result in an emergency room visit or hospitalization.
- Use of oral corticosteroids once or less per year.
Poorly controlled or uncontrolled asthma can develop acutely or come on slowly over time. These factors are indicators that asthma is not being controlled for adults and children with asthma:
- Symptoms start to occur more often, are more severe, or occur at night and cause sleep disruption
- Limiting or stopping activities due to asthma symptoms.
- Missing school or work because of asthma symptoms.
- Asthma medicines don't seem to work anymore.
- Using a quick-relief inhaler more than two times a week (outside of premedication).
- Having to go to the emergency room or see a medical provider because of an asthma attack.
Patients with asthma should have a minimum of one visit with their health care provider each year to assess level of control and adjust treatment as needed. They should also have annual screening of lung function with pulmonary function testing (primarily spirometry). Patients may require more frequent visits with their health care provider, more frequent spirometry or pulmonary function testing, and/or more medication adjustments during periods of poor asthma control.
In 1997, the National Health, Lung, and Blood Institute and the National Asthma Education and Prevention Program (NHLBI/NAEPP) published an update on their report, “Guidelines for the Diagnosis and Management of Asthma.” These guidelines provide information and tools to assist health care providers and patients when making decisions about asthma care and appropriate treatment. The main goal of asthma treatment is to reduce or eliminate asthma symptoms using the least amount of medicine to achieve good control. Patients should be able to fully participate in their daily activities and achieve life goals without interference from their asthma. It may be helpful to review and discuss the NHLBI/NAEPP guidelines for management of your asthma at the next visit with your health care provider.
Successful control of asthma requires that patients and caregivers take an active role in their care and work in collaboration with their health care provider. Unfortunately, there is no known cure for asthma, but asthma can be controlled with proper treatment, avoidance of triggers and working closely with your health care provider to regularly assess control and determine appropriate treatment. In honor of “National Asthma and Allergy Awareness Month,” schedule a visit with your health care provider for an asthma check-up for you or your child today!
Joy Fladager Muth, APRN, CNP, is a primary care pediatric nurse practitioner with Employee and Community Health's (ECH) Division of Community Pediatric and Adolescent Medicine. She serves as the team lead for the ECH Asthma Management Program (AMP) and is one of four pediatric providers in the role of an Integrated Community Specialist (ICS). In her ICS role, Ms. Green provides expert asthma care and consulting services for ECH pediatric patients with asthma in collaboration with Mayo's Pediatric Pulmonology and Pediatric Allergy specialty providers.