Severe Asthma ToolkitSevere Asthma Toolkit
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  • What is Severe Asthma?
    • Overview
    • Definition
    • Prevalence & Burden
    • Pathophysiology
    • Symptoms
    • Severe Asthma Attacks / Exacerbations / Flare-ups
    • Asthma Phenotypes
  • Diagnosis & Assessment
    • Overview
    • Diagnosis Overview
    • Assessment Overview
    • Lung Function Assessments
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    • Phenotyping
    • Bronchoscopy
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    • Occupational Asthma
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    • Overview
    • Asthma Education
      • About Severe Asthma
      • Asthma Pathophysiology
      • Medications Education
      • Self-Monitoring
      • Triggers
      • Review
    • Written Action Plans
    • Adherence
    • Inhaler Technique
    • Physical Activity & Exercise
    • Interdisciplinary Approach & Multidimensional Assessment
    • Referral
  • Medications
    • Overview
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    • Add-on Therapies
    • Monoclonal Antibodies
    • Bronchial Thermoplasty
  • Co-Morbidities
    • Overview
    • Pulmonary & Upper Airways
      • Allergic & Non-Allergic Rhinitis
      • Chronic Rhinosinusitis
      • Dysfunctional Breathing
      • Vocal Cord Dysfunction
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      • Bronchiectasis
      • Obstructive Sleep Apnoea
    • Extra-Pulmonary
      • Obesity
      • Anxiety & Depression
      • Gastro-oesophageal Reflux Disease (GORD)
      • Osteoporosis
      • Cardiovascular Disease & Metabolic Disease
  • Living with Severe Asthma
    • Overview
    • Daily Symptom Burden
    • Mental & Emotional Health
    • Intimacy & Relationships
    • Self-Management Support
    • Medication Use & Costs
    • Experience of Care
    • Experience of Asthma Attacks
    • Prognosis
  • Establishing a Clinic
    • Overview
    • Set-up
    • Staffing & Multidisciplinary Team Approach
    • Facilities
    • Delivery Approach
    • Tailored Referrals
    • Evaluation
    • Opportunities for Training & Research
    • Barriers & Hurdles
  • Paediatrics
    • Overview
    • Management in Paediatrics
    • Assessment in Paediatrics
    • Alternative Diagnosis & Co-Morbidities in Paediatrics
    • Psychosocial Issues in Paediatrics
    • Medications in Paediatrics
    • Asthma in the Adolescent Population
  • Resources
    • Overview
    • Clinic Recommendations
    • Infographics
    • Asthma Assessment Resources
    • Systematic & Multidimensional Assessment Resources
      • Airway Components
      • Comorbidity Components
      • Risk Factor Components
    • Translation & Implementation
    • Case Studies
    • Presentations
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    • Relevant Links
    • Key References

Overview

Home Diagnosis & Assessment Overview
Patient and doctor receiving a severe asthma diagnosis
LAY OVERVIEW

Before diagnosing a person with severe asthma it is important to consider if their symptoms may be due to another medical problem or complicating factors. They may also have symptoms due to poor treatment adherence or inhaler technique.

Severe Asthma Diagnosis

Before applying a diagnosis of severe asthma, it is important to recognise:

  1. Some patients referred to severe asthma clinics do not have severe asthma. They may have an alternate diagnosis, or another diagnosis is influencing their symptoms
  2. Many patients have high symptom burden and are prescribed high-dose treatment. They do not necessarily have severe asthma but rather may have:
    • Poor treatment adherence
    • Poor inhaler technique

A profile of difficult to treat asthma patients referred to a Australian severe asthma clinic is available in (Radhakrishna et al. 2016)

Therefore, the first and most important questions to answer are:

  • Is it asthma?
  • Is the asthma severe?

The diagnostic process follows a simple schema, based on a thorough clinical assessment (not diagnostic tests).

The Centre of Excellence Severe Asthma has also developed a checklist to inform the diagnosis and characterisation of severe asthma in the clinic.

Diagnosis Overview

Detailed Assessment

  • Fully characterising severe asthma is critically important, its value in management cannot be overstated
  • Clinical characterisation (often called phenotyping), determines management and treatment strategies
  • Comprehensive systematic and multidimensional assessment improves asthma outcomes (Clark et al. 2017).

Note: Results of investigations may uncover causes of uncontrollable, asthma-like symptoms. These may occur in people with severe asthma, non-severe asthma or non-asthma conditions (e.g. bronchitis, bronchiectasis, obesity, rhinitis) and provide targets for treatment (i.e. treatable traits). Therefore, a multi-dimensional assessment is a useful approach to airways disease in general.

Assessment Overview
algorithm for severe asthma assessment and severe asthma diagnosis

An algorithm to guide diagnosis and assessment in individuals with suspected severe asthma.

Read more
Click here to download a printable version of the infographic below.

Access the full suite of infographics here.

severe asthma diagnosis assessment infographic

Last Updated on September 22, 2022

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  • Overview
  • Diagnosis Overview
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  • Bronchoscopy
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  • Occupational Asthma

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