Among most people with asthma, the right therapy allows to keep asthma under control. Assessment of asthma control includes checking your symptom control and assessing your risk of having future problems including asthma attacks.
To assess symptom control, your doctor will ask you about the following in the last four weeks:
- How frequent were your asthma symptoms
- If you had any night waking due to asthma
- If you had any limitation of activity due to asthma
- If you use a SABA reliever, how often did you use it to relieve your symptoms (this doesn’t include reliever routinely taken before exercise)
Asthma control means more than just controlling your symptoms, as patients who have infrequent asthma symptoms can still have severe asthma attacks. The doctor will also assess your risk of future problems, particularly exacerbations (attacks), persistent airflow limitation, and side effects of medications.
Severe asthma attacks (exacerbations)
The following factors that can be easily identified by your doctor can increase your risk of severe asthma attacks :
- Your asthma symptoms are not under control
- You experienced one or more severe attack in the previous year
- You are not prescribed an inhaled corticosteroid-containing medication
- You are not adherent with your prescribed inhaled corticosteroid-containing treatment
- You are not able to use your inhaler properly
- You use more than two SABA inhalers in a year
- As well as asthma, you have chronic sinusitis, obesity, reflux or confirmed food allergy
- You are a smoker
- You are exposed to air pollution inside or outside the home
- You have social or economic problems that interfere with your ability to access health care and medications
In children, the risk of severe asthma attacks is also greatly increased if they are not receiving inhaled corticosteroid therapy, and if they also have other types of allergic disease such as food allergy. Children living in poverty have been found to have a higher risk of severe asthma attacks.
Talk to your doctor if you or your child have any of these problems, because many can be treated.
Persistent airflow limitation
As we get older, our lung function test results gradually get lower. However, a small proportion of people with asthma have a faster than usual drop in their lung function, and develop persistent airflow limitation. This means that their lung function doesn’t respond to asthma medications as much as when they were younger. The following factors increase the chance that you may develop persistent airflow limitation:
- Exposure to cigarette smoke or chemicals
- Coughing mucus every day
- People who are not taking an inhaled corticosteroid medication and experience asthma attacks
Side effects of medications
Asthma medications should always be prescribed by your doctor. Carefully follow the indications of your healthcare provider on the dose and on the inhaler technique.
Based on the level of control, your doctor can help you take appropriate action to better manage your asthma.