Information for Health Professionals
Updated Guidelines for Your Patients with Asthma
The 2007 update of the National Asthma Education and Prevention Program's (NAEPP) Guidelines for the Diagnosis and Management of Asthma (EPR-3)1 emphasizes the importance of consistent and comprehensive asthma control for the health of your patients with asthma. The guidelines are now fully evidence-based and include revised approaches to:
Assessment and Monitoring, 2 emphasizing the use of multiple measures of the patient's level of current impairment, including frequency and intensity of symptoms, low lung function, limitations of daily activities, and future risk (risk of exacerbation; progressive loss of lung function; adverse side effects from medications). The new guidelines stress that some patients can still be at high risk for frequent exacerbations even if they have few day-to-day effects of asthma.
Patient Education, 2 with emphasis on:
- teaching patients skills to self-monitor and manage asthma
- using a written asthma action plan that includes instructions for daily treatment and ways to recognize and handle worsening asthma
- the importance of expanding educational opportunities to reach patients in a variety of settings, such as pharmacies, schools, community centers, and patients' homes
Control of environmental factors and other conditions that can affect asthma, 2 stressing:
- multiple approaches to limit exposure to allergens and other substances that can worsen asthma
- treatment of other conditions that asthma patients can have such as rhinitis and sinusitis, gastroesophageal reflux, obesity, obstructive sleep apnea, stress, and depression which may improve asthma control
- treatment tailored to the particular characteristics of a patient's asthma and genetic makeup
Medications, 2 with emphasis on 6-part stepwise approach to asthma management.1 EPR-3 recommends that:
- the level of asthma control must be monitored periodically to determine whether therapy should be maintained or adjusted
- clinicians should assess severity to initiate therapy and assess control to adjust therapy
- patient adherence to medication, inhaler technique, and environmental control measures should be assessed before making a step up in therapy
The new guidelines reaffirm that patients with persistent asthma need both long-term control medications to control asthma and prevent exacerbations, and quick relief medications for symptoms as needed; and that inhaled corticosteroids are the most effective single long-term control medication across all age groups.
