In order to carefully monitor your asthma according to National Institutes
of Health guidelines, a doctor will generally do the following:
- Classify the severity of your asthma at the initial diagnosis according
to the NAEPP classification system.
- Help you set goals and work with you to achieve them.
- Recommend measures to control asthma triggers, such as tobacco smoke, house
dust mites, or cockroach, dog, or cat allergens.
- Provide you with a written "action plan" that explains how to manage your
asthma on a daily or regular basis. These instructions should include what
to do during an asthma attack.
- If you have moderate-to-severe persistent asthma, teach you how to monitor
your peak flow and your asthma signs. Give you a record chart to track the
results each day. (Some children may be too young for symptom or peak flow
- Answer your questions and check to make sure you understand your medications.
- Adjust your treatment plan as needed. The doctor should be able to optimize
your treatment plan, so that your asthma is under control and side effects
At each visit, the physician will:
- Ask you whether your asthma symptoms are impacting your life in any way.
- Examine you and sometimes do formal breathing tests. Spirometry, or at
least peak flow measurement, should be done at the time you are first assessed,
after your symptoms have first been brought under control, and then at least
every one to two years to make sure your asthma is still under control.
- Classify the severity of your asthma according to the NAEPP classification
system at each asthma office visit.
- Assess for referral to specialty care, recommend in any of the following
- A single life-threatening asthma event.
- Treatment goals are not being met within 3 weeks - 6 months of treatment,
or the asthma is not responding to therapy.
- Asthma diagnosis unclear.
- Patient’s asthma classification is severe persistent asthma.
- Patient is under age 3 with moderate persistent asthma.
- Patient is a candidate for immunotherapy.
- Patient has required more than two courses of oral steroids in a year,
or continuous high-dose inhaled steroids.
- Patient needs additional education or guidance.
- See if you understand your written action plan and assess your level of
satisfaction with the treatment.
- Verify at each visit how and how much you use your medications, inhalers,
or peak flow meter.
Williams SG, Schmidt DK, Redd SC, Storms W. Key clinical activities for quality
asthma care: recommendations of the National Asthma Education and Prevention
Program. MMWR Recomb Rep. 2003 Mar 28;52(RR-6):1-8.
Review Date: 5/16/2007
Reviewed By: Alan Greene, M.D., F.A.A.P., Department of Pediatrics, Packard Children's Hospital, Stanford University School of Medicine; Chief Medical Officer, A.D.A.M., Inc.
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