Antibiotics & Sinus Infections | Curbing Use of Antibiotics | Hormone pills & asthma | CDC Asthma Recommendations
National Jewish Medical & Research Center
American Academy of Allergy, Asthma & Immunology
National Institute of Allergy & Infectious Disease
Allergy & Asthma Network Mothers of Asthmatics
American Lung Association
Office: 440-333-2003
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440-356-7806
20455 Lorain Road, Suite T3
Fairview Park, Ohio 44126
In 2002, the National Asthma Education and Preventions Program (NAEPP) issued an updated version of the Expert Panel Report: Guidelines for the Diagnosis and Management of Asthma. Recently, the CDC, in collaboration with the NAEPP, issued a companion to that report, detailing 10 key clinical activities for quality asthma care, along with steps to help implement them. The CDC's recommendations include:
Diagnosis of asthma and its level of severity should be made when the patient first seeks medical attention for symptoms. For adults and children older than 5, asthma can be diagnosed using physical examination, medical history, and spirometry (results should indicate reversible obstruction). Since spirometry is not feasible in children younger than 5, young children with asthma symptoms should be treated as having suspected asthma.
Routine follow-up is important because patients can experience changes in symptoms or severity. The first follow-up visit should occur one month after initial diagnosis. Thereafter, routine visits should be scheduled every one to six months, depending on asthma severity and the patient's symptom control.
The following circumstances indicate the need for referral to specialty care:
Comorbid conditions, such as allergic rhinitis, sinusitis, gastroesophageal reflux, and sensitivity to certain medications (including aspiring, β-blockers, and nonsteroidal anti-inflammatory drugs), should be treated to prevent exacerbations.
Medications should be prescribed according to asthma severity. All patients with persistent asthma, regardless of severity, need daily long-term control medication. Inhaled corticosteroids are the most effective because they reduce the underlying inflammation. At each patient visit, use of inhaled ß-agonists should be reviewed and additional long-term control therapy initiated if needed.
A written asthma management plan should be developed for all patients. The plan should include tips on how to recognize worsening asthma, how to use medications appropriately, when to seek medical care, and how to monitor treatment response.
The full text of "Key Clinical Activities for Quality Asthma Care" is available online at the Centers for Disease Control site.