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Understanding Mild Asthma

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Understanding Mild Asthma

According to the Global Initiative for Asthma (GINA), 50-75% of all patients with asthma have mild asthma (mild intermittent and mild persistent asthma). Severe exacerbations, or flare-ups, in mild asthma represent about one-third of all asthma exacerbations resulting in emergency services.

Patients at any level of severity, even intermittent asthma, are at risk for a life-threatening exacerbation. This is especially true if you do not appropriately self-manage your asthma.

The new asthma guidelines, released in 2007, recommend patients with intermittent, persistent mild, or moderate asthma see their clinician minimally every six months if their asthma has been under control (at least for the preceding three months). If your asthma is uncontrolled or is classified as severe persistent asthma, you need to be seen more often.

It is essential that you be able to immediately recognize symptom patterns that may indicate inadequate control of your asthma. Your ability to recognize these symptoms is crucial:

• Daytime asthma symptoms
• Nocturnal awakenings
• Frequent use of short-acting beta agonists for relief of symptoms
• Inability or difficulty in performing normal activities (including exercise) because of asthma symptoms.

The updated asthma guidelines also recommend that all patients receive a written asthma action plan that includes daily treatment and how to recognize and manage worsening asthma, including self-adjustment of medications in response to acute symptoms or changes in peak flow measurements. The guidelines particularly recommend that patients who have persistent moderate or severe asthma have an action plan.

The goals for asthma control focus on the need to reduce impairment, which includes:

• Chronic and troublesome symptoms
• Frequent use of short-acting beta agonist therapy
• Pulmonary function test results that are not normal for the patient
• Inability to maintain normal activity levels
• Not meeting their own or their family's expectations.

It is also essential that the risk of a flare-up be reduced by:

• Preventing recurrent exacerbations or emergency department visits
• Preventing progressive loss of lung function
• Optimizing use of medications and devices so that there are minimal or no side effects.

Asthma is a dynamic disease process, so it is important to practice good self-management. It helps to keep your doctor or therapist informed of your changes in asthma control so they can intervene in a timely manner.