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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
1 in 13 adults).
• Each year, asthma accounts for more than 439,000 hospitalizations,
1.7 million emergency department (ED) visits and 13.8 million
1
missed school days.
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• Asthma costs about $50 billion each year in healthcare costs.
• 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
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group.
• More than 60% of adults and 50% of children with current asthma
2,3
have uncontrolled asthma.

Asthma is a chronic respiratory disease requiring ongoing medical
management. When controlled, asthma has a minimal impact on every-
day 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, hos-
2,3
pitalization, and work and school absenteeism.
Most people with asthma should be able to control their disease with
proper care. Asthma education and self-management are essential com- • Periodic spirometry can also help assess progressive loss of lung func-
ponents of successful asthma management. When healthcare providers tion over time.
deliver asthma care based on evidence-based asthma guidelines, patients • Incorporation of a written asthma action plan into routine visits can
can experience better health outcomes and quality of life. serve several functions such as daily asthma care, attack management
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and indications for emergency care.
Asthma attack prevention
Important strategies in asthma attack prevention include routine vis- Read the American Lung Association: Create an Asthma Action
its, recognition of symptoms, understanding the use of medications, Plan at https://www.lung.org/lung-health-diseases/lung-disease-
proper inhalation technique, avoidance of triggers, monitoring and the lookup/ asthma/living-with-asthma/managing-asthma/create-an-
use of premedication in certain situations. asthma-action-plan.

Routine follow-up care: Scheduling office visits every 6-12 months Asthma symptoms:
or more often if indicated is an essential part of caring for patients with Patients should understand how to recognize early symptoms of a
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asthma. potential asthma attack, such as shortness of breath, wheezing, chest
• Assessing control should be incorporated into every routine asthma tightness and recurrent coughing.
visit and is the basis for stepwise management of asthma medica-
tions. This can be done using a questionnaire that the patient com- Role of medications: The differences between quick-relief medica-
pletes prior to their visit. Standardized questionnaires, such as the tion and long-term controller medications should be discussed.
Asthma Control Test and Asthma Control Questionnaire are in- Single Maintenance and Reliever Therapy (SMART) can be consid-
formative and easy to use. ered for select patients. Rather than an inhaled corticosteroid for daily

14 SAN ANTONIO MEDICINE • June 2022