Asthma treatment: 3 steps to better asthma control

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Asthma treatment: 3 steps to better asthma control

Effective asthma treatment requires routinely tracking symptoms and measuring how well your lungs are working. This information can be used to adjust your asthma treatment in keeping with the plan you made with your doctor. Taking an active role in managing your asthma treatment will help you maintain better long-term asthma control, prevent asthma attacks and avoid long-term problems.

Create a written asthma action plan with your doctor. This written plan will serve as an asthma treatment guide tailored to your specific needs. It will help you follow these three important steps and keep a good record of your asthma treatment:

1. Track your symptoms

Write down your symptoms in an asthma diary each day. Recording symptoms can help you recognize when you need to make treatment adjustments according to your asthma action plan. Use your asthma diary to record:

  • Shortness of breath or whistling sounds when you exhale (wheezing)
  • Disturbed sleep caused by shortness of breath, coughing or wheezing
  • Chest tightness or pain
  • Quick-relief (rescue) inhaler use — record when you need to use your quick-relief inhaler (such as albuterol) and write down how many puffs you take
  • Disruptions to work, school, exercise or other day-to-day activities caused by asthma symptoms
  • Asthma symptoms during exercise
  • Changes in color of phlegm you cough up
  • Hay fever symptoms such as sneezing and runny nose
  • Anything that seems to trigger asthma flare-ups

2. Record how well your lungs are working

Your doctor may have you periodically record results of breathing tests (lung function tests). If your lungs aren't working as well as they should be, your asthma may not be under control. There are two main lung function tests:

  • Peak flow. This test is done at home with a simple hand-held device called a peak flow meter. A peak expiratory flow (PEF) measurement indicates how fast you can force air out of your lungs. Peak flow readings are sometimes gauged as a percentage of how your lungs work at their best. This is called your personal best peak flow.
  • Spirometry. Spirometry tests can be done at your doctor's office with a machine called a spirometer. Some people use a hand-held spirometer to take measurements at home. Spirometry tests measure how much air your lungs can hold and how much air you can exhale in one second after you've taken a deep breath. This measurement is called forced expiratory volume (FEV). Your FEV measurement is compared with the typical FEV for people who don't have asthma. As with your peak flow reading, this comparison is often expressed as a percentage.

3. Adjust treatment according to your asthma action plan

When your lungs aren't working as well as they should be, you may need to adjust your medications according to the plan you made with your doctor ahead of time. Your written asthma action plan will let you know exactly when and how to make adjustments.

The chart below can help you determine if you're doing a good job of keeping your asthma under control. A similar system should be included in your asthma action plan. Depending on where your asthma control falls on the chart, you may need to make adjustments to your medications.

Levels of asthma control in children over 12 and adults

  Well-controlled
'Green zone'
Poorly controlled
'Yellow zone'
Very poorly controlled
'Red zone'
Symptoms such as coughing, wheezing or shortness of breath Two days a week or fewer More than two days a week Daily and throughout the night
Nighttime awakenings Two times a month or fewer One to three times a week Four times a week or more
Effect on daily activities None Some limits Extremely limiting
Quick-relief inhaler use to control symptoms Two days a week or fewer More than two days a week Several times a day
Lung test readings More than 80% of your predicted personal best 60 to 80% of your predicted personal best Less than 60% of your predicted personal best

There are two main types of medications used to treat asthma:

  • Long-term control medications such as inhaled corticosteroids are the most important medications used to keep asthma under control. These preventive medications treat the airway inflammation that leads to asthma symptoms. Used on a daily basis, these medications can reduce or eliminate asthma flare-ups.
  • Quick-relief inhalers contain a fast-acting medication such as albuterol. These medications are sometimes called rescue inhalers. They're used as needed to quickly open your airways and make breathing easier. Knowing when to use these medications can help prevent an impending asthma attack.

Long-term control medications are the key to keeping your asthma in the green, or well-controlled, zone. If you frequently use a quick-relief inhaler to treat symptoms, your asthma isn't under control. See your doctor about making treatment changes.

Make sure you know how to use your asthma medications properly. They will only keep your asthma under control if you use them correctly.

Work with your doctor

Asthma symptoms and severity are always changing. Following your plan will help you avoid asthma attacks and minimize the disruptions caused by asthma symptoms.

Meet with your doctor regularly to review your treatment. Take your asthma diary and action plan with you so you can review them with your doctor and make any needed changes to your treatment plan.

Reasons you might adjust your medications include:

  • If you're still having bothersome symptoms even though you're following your plan, talk to your doctor about possibly increasing or changing your medications.
  • If your asthma is well controlled, you may be able to reduce the amount of medication you take.
  • If you have seasonal allergy triggers, your asthma medication may need to be increased at certain times of the year.
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