Attaining asthma control

Current Opinion in Allergy and Clinical Immunology
John J Oppenheimer, James Li

Abstract

Despite our knowledge of asthma pathophysiology and several guidelines, studies have indicated growing morbidity. This review highlights the rationale for the trend in asthma care of separating asthma control from asthma severity. Recent research has highlighted why asthma morbidity continues to be such a conundrum. This includes the variability of asthma control over time, inability to achieve total asthma control in some patients, disagreement between various measures of asthma control and the lack of an agreed tool for determining asthma control. By dissociating asthma control and severity, the clinician may focus on the level of control during each encounter, independent of asthma medication. One can still build upon the step-up and step-down algorithm, while reinforcing control of asthma as the ultimate goal. Asthma control connotes the status of the disease, highlighting the dynamic nature of this illness both as the response to a trigger as well as therapy. Although more aggressive intervention may be required to achieve adequate control in severe persistent asthma versus mild persistent disease, the goal of appropriate asthma control remains constant in the spectrum of asthma severity.

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Citations

Jun 15, 2007·The Journal of Allergy and Clinical Immunology·Hubert ChenUNKNOWN TENOR Study Group
Sep 4, 2010·The Journal of Asthma : Official Journal of the Association for the Care of Asthma·Judith FifieldJoan Twiggs
May 19, 2010·Expert Review of Clinical Immunology·Claus Kroegel

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