PREVENTATIVE MEDICINE
Key Ashtma Management Strategies to Prevent Asthma Attacks By John F. Freiler, MD
Asthma Fast Facts • More than 26 million Americans have asthma (1 in 12 children and 1 in 13 adults).1 • Each year, asthma accounts for more than 439,000 hospitalizations, 1.7 million emergency department (ED) visits and 13.8 million missed school days.1 • Asthma costs about $50 billion each year in healthcare costs.1 • Every day, about 10 people die of asthma. Black Americans are 2-3 times more likely to die from asthma than any other racial or ethnic group.1 • More than 60% of adults and 50% of children with current asthma have uncontrolled asthma.2,3 Asthma is a chronic respiratory disease requiring ongoing medical management. When controlled, asthma has a minimal impact on everyday living. Uncontrolled asthma with frequent and intense episodes of symptoms can have a significant cost to families and society because it may relate to an increased risk of an emergency department visit, hospitalization, and work and school absenteeism.2,3 Most people with asthma should be able to control their disease with proper care. Asthma education and self-management are essential components of successful asthma management. When healthcare providers deliver asthma care based on evidence-based asthma guidelines, patients can experience better health outcomes and quality of life.4 Asthma attack prevention Important strategies in asthma attack prevention include routine visits, recognition of symptoms, understanding the use of medications, proper inhalation technique, avoidance of triggers, monitoring and the use of premedication in certain situations. Routine follow-up care: Scheduling office visits every 6-12 months or more often if indicated is an essential part of caring for patients with asthma.4 • Assessing control should be incorporated into every routine asthma visit and is the basis for stepwise management of asthma medications. This can be done using a questionnaire that the patient completes prior to their visit. Standardized questionnaires, such as the Asthma Control Test and Asthma Control Questionnaire are informative and easy to use. 14
SAN ANTONIO MEDICINE • June 2022
• Periodic spirometry can also help assess progressive loss of lung function over time. • Incorporation of a written asthma action plan into routine visits can serve several functions such as daily asthma care, attack management and indications for emergency care. Read the American Lung Association: Create an Asthma Action Plan at https://www.lung.org/lung-health-diseases/lung-diseaselookup/ asthma/living-with-asthma/managing-asthma/create-anasthma-action-plan. Asthma symptoms: Patients should understand how to recognize early symptoms of a potential asthma attack, such as shortness of breath, wheezing, chest tightness and recurrent coughing. Role of medications: The differences between quick-relief medication and long-term controller medications should be discussed. Single Maintenance and Reliever Therapy (SMART) can be considered for select patients. Rather than an inhaled corticosteroid for daily
