Regulation and Control

Asthma management, as outlined by NIH can best be achieved through a combination of regular assessment and monitoring, trigger control, pharmacotherapy and patient education. Spirometry is primarily used to evaluate lung function for asthma diagnosis, whereas peak flow meters are often used to monitor lung function at home and at many outpatient appointments. Patients can determine their personal optimum peak expiratory flow (PEF) by identifying their best score during several weeks when the disease is under best control. Eighty percent or better than the patient’s personal best PEF score is considered to be good control. Sixty to seventy-nine percent of the patient’s personal best PEF score is considered to indicate caution. Less than 60% of personal best score indicates a medical alert. The PEF is often taken twice each day expecting the lowest score in the early morning upon wakening, while the highest score is expected early to mid-afternoon.

Patients and families need information and discussions about the disease, medications, monitoring, trigger control, assessment and management of exacerbations. Asthma patients should receive a written asthma action plan to help guide self-management efforts. Additionally they should have an initial severity assessment, including current impairment measures, treatments and future risk. Also they should have planned follow-up visits for continuing assessments and treatment adjustments. Finally, asthma patients should receive a review of potential allergens and irritants in order to reduce exposure to those that might make asthma worse.