Asthma management

The recipe for successful asthma management is a combination of the right treatment and, sometimes, lifestyle measures. Most patients can manage their asthma, keep symptoms under control and, in most cases, live with no or few limitations.

There are many tools that can help you to achieve good asthma control and to prevent attacks. ICS-containing drug treatment is the main tool with which to control asthma. The type of treatment depends on how severe your asthma is and how well it is controlled, but it also depends on your goals and expectations.

Monitor your asthma symptoms

Self-monitoring of symptoms can be useful in managing asthma. Take time to record in your daily asthma journal:

  • Exacerbations and the time needed to recover
  • The need for reliever medications (e.g., need of more than one can of SABA per month)
  • Appearance of symptoms
  • Triggers that may worsen your asthma

You may also use a peak flow meter to monitor how your lung function is going. A compressed PEF chart (showing two months on a landscape format page) can make it easier to identify patterns in your lung function.

Bring the journal and the PEF chart with you at each consultation

Asthma action plan

The written asthma action plan helps you to manage your asthma when your symptoms are getting worse. The asthma action plan is a personalised written document prepared with your doctor based on your treatment needs. It describes situations and symptoms that you should monitor in order to adapt the treatment without consulting the doctor every day. It also includes information on when it is necessary to contact the doctor to review the treatment.

The advice on your action plan will be different depending on whether your reliever is an anti-inflammatory reliever (budesonide-formoterol or beclometasone-formoterol) or a SABA.

Comply with asthma treatment

Following exactly the prescribed medication is crucial for a successful treatment. Maintenance treatment must be taken every day once or twice daily. Make it part of your routine! The first step to optimise treatment is to agree with your healthcare provider on the treatment that best meets your needs and expectations and that you are able to use correctly.

Ask questions about your asthma treatment

  • Take time to ask your doctor when is the best time of the day to take the medicine, what to do if you forget to take the medicine, and any questions that you may think of that may relieve your mind of the burden of organising your daily medications.
  • Make sure that the differences between reliever and maintenance therapy are clear to you.
  • Remember that asthma does not always keeps the same and it can change over time after diagnosis.
  • Ask your doctor to talk you through each step of your action plan, and review it together at each visit. You may have doubts you did not think of during the first visit.
  • Openly discuss with your doctor any fears or concerns about your medications, for example if you are pregnant, if you are concerned about allergies or interactions with other medicines, etc.

Practice using your asthma inhaler

Most asthma treatments are delivered directly to the lungs via an inhaler . Inhalers are considered complex drug-device combinations that require training. There are different types of inhalers, the doctor will advise which is the best for you depending on your needs. Knowing how to use your inhaler means to ensure that the drug is delivered correctly to the lungs.

Inhalation requires to breathe in the medicine with more or less intensity depending on the drug. Generally speaking, if you are prescribed pressurised metered dose inhalers (puffers) you should take a slow breath in, while if you use dry powder inhalers, you should take a strong breath in. Your healthcare provider will explain how to use the inhaler but it may require some practice.

Usually, manufacturers provide patient resources to show how the inhaler should be used, and there are websites with good demonstration videos. Ask your doctor and pharmacist for online resources in your language.

Do it together!

  • Ask your healthcare provider to check your inhaler technique. Take your inhaler with you at each consultation.
  • Ask the pharmacist to show you the device and to explain in detail how it works.
  • Online training videos may be very helpful when practising your inhaler technique. Check patients’ organisations and medical societies websites.
More #aboutasthma
Is it asthma?
What is an asthma attack?
How to communicate about asthma with healthcare providers
Master your asthma action plan
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