Attaining Optimal Asthma Control: A Practice Parameter
A new practice parameter on the treatment of asthma emphasizes the need for asthma to be assessed each time a patient with asthma sees his or her physician or other health care professional. Based on the assessment, the patient's asthma should be assessed as either well controlled or not well controlled, with appropriate changes made to medication and management plans.
Attaining Optimal Asthma Control: A Practice Parameter, which is featured in the November 2005 Journal of Allergy & Clinical Immunology (JACI), was developed by the Joint Task Force on Practice Parameters for Allergy & Immunology, a joint coalition of the American Academy of Allergy, Asthma & Immunology (AAAAI), and the American College of Allergy, Asthma & Immunology (ACAAI). Click here to view the new practice parameter.
The following questions and answers are designed to patients with asthma and healthcare professionals understand the recommendations in the new practice parameter.
What makes asthma a chronic disease?
Asthma is an ongoing, long-term disease that affects the breathing passages. Like any other chronic disease, asthma is a condition you live with every day of your life, with symptoms changing significantly over time. Asthma requires continuous management and appropriate treatment. [Back]
Should asthma symptoms be assessed at every physician visit?
Yes, the new practice parameter recommends that asthma control be assessed at every clinic visit for asthma. Asthma symptoms can change dramatically over a short period of time. Assessment of asthma control at every visit ensures that proper treatment is being given. [Back]
Why should asthma be classified as either well controlled or not well-controlled?
The new practice parameter emphasizes that asthma management be driven by the level of asthma control. Classifying asthma as either well controlled or not well controlled will guide the decision to increase or decrease treatment. Complete or well controlled asthma may require unchanged or step-down therapy while uncontrolled asthma involves a more detailed evaluation of asthma, including a possible increase in medication and more frequent doctor visits. [Back]
How do I know if my asthma is well controlled?
Well-controlled asthma is defined as:
- Asthma symptoms are twice a week or less
- Rescue bronchodilator medication is used twice a week or less
- There is no nighttime or early morning awaking
- There are no limitations at work, school or during exercise
- Patient and physician consider their asthma well controlled
- Patients peak flow is normal or at personal best
[Back]
How do I know if my asthma is not well controlled?
Signs of uncontrolled asthma are any of the following:
- Asthma symptoms occur more than twice a week
- Rescue bronchodilator medication is used more than twice a week
- Nighttime or early morning awaking occurs
- There are limitations at work, school or during exercise
- Your physician and you consider your asthma not well controlled
- Your peak flow is not normal and you are not at your personal best
[Back]
What should a physician or other healthcare provider assess during a visit?
During every visit, the healthcare provider should:
- Review asthma action plan
- Assess psychosocial status
- Assess adherence/compliance
- Assess if asthma symptoms cough, chest tightness, shortness of breath and wheezing are present
- Assess medication's side effects
- Assess asthma triggers
- Confirm/reconfirm diagnosis of asthma
[Back]
The role of the allergist/immunologist
To help gain well or complete asthma control, the AAAAI recommends working with an asthma specialist, such as an allergist/immunologist, who is the best qualified medical professional trained to manage the prevention, diagnosis and treatment of allergies and asthma.
Studies have shown that patients with asthma under the care of an allergist/immunologist were significantly less likely to require treatment in an emergency room due to their asthma. Allergy specialty care also reduces hospitalizations, improves quality of life and reduces healthcare costs.
To find an allergist/immunologist in your area, visit the AAAAI's Find an Allergist/Immunologist directory.
Additional Resources
 Assess Your Asthma - take a short quiz that will help you decide if your asthma is well controlled or not
AAAAI Patient Gallery
School Nurse Tool Kit:
 What is asthma
My asthma action plan
Student asthma action card
AAAAI Allergy & Asthma Medication Guide
Tips to Remember: Asthma Triggers and Management
Tips to Remember: Role of the Allergist/Immunologist
Medication Guide
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