Asthma action plans

The single most important part of understanding how to control your asthma is to develop an understanding of the severity of your own particular problem and developing a plan to deal with it. The National Heart, Lung, Blood Institute (NHLBI), a division of the National Institutes of Health (NIH) has created the following chart to help patients and physicians to gauge the severity of their symptoms. Once we can get an accurate assessment of the range of symptoms, we can begin to understand the particular triggers (see asthma link) and prescribe the appropriate medication(s) for each level of severity.

Since airway inflammation is a serious chronic problem, our goal is to maximize the number of days that each bronchus (airway) is in the normal state. For all patients who can utilize the peak flow meter reliably, we first compare their personal best with the following chart of normal values.

Then we create a treatment plan using the asthma action plan format, click image on right for a printable Adobe Acrobat .pdf verision of the Asthma Action Plan.

Each zone in the Asthma Action Plan calls for either a controller medication or a reliever/rescue medication or both. How many or how much of these medications is determined by reviewing your personal history using the following chart of intermittent through severe persistent asthma.

The Asthma Action Plan that we create together is an ever-evolving plan that will change depending on growth, sensitivities, seasonal shifts, etc. Please review the plan with us each time you visit or call especially during your at risk seasons. It is particularly important to read the NHLBI's first statement that "even mild persistent asthma is a long term risk and needs to be treated properly."

Persistent asthma is an inflammatory disease that requires regular anti-inflammatory therapy

Experts believe:

• Inflammation is an early and persistent component of asthma
• If left untreated, airway inflammation contributes to:
  - decreased lung function
  - symptoms of asthma
  - possible long-term lung damage

Airway remodeling occurs even in mild asthma. Stepwise approach to managing asthma long term for adults and children older than 5 years of age is the key to successful outcomes.

Classification of Asthma Sympton Serevity and Therapy

Please view or print the 'Symptom Severity and Therapy' chart on the left that is in a .pdf Adobe Acrobat format. To download Adobe's free Acrobat Reader just click the on the icon below.

October 2002