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
    • Questionnaires
    • Allergy Assessments
    • Phenotyping
    • Bronchoscopy
    • Imaging
    • Occupational Asthma
  • Management
    • 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
    • Relievers
    • Preventers / Controllers
    • Add-on Therapies
    • Monoclonal Antibodies
    • Bronchial Thermoplasty
  • Co-Morbidities
    • Overview
    • Pulmonary & Upper Airways
      • Allergic & Non-Allergic Rhinitis
      • Chronic Rhinosinusitis
      • Dysfunctional Breathing
      • Vocal Cord Dysfunction
      • Chronic Obstructive Pulmonary Disease
      • 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
    • Videos
    • Relevant Links
    • Key References

About Severe Asthma

Home Management About Severe Asthma

There are different types of asthma. For most patients with mild asthma, it can be well controlled with low doses of inhaled preventers. For a small proportion of patients, asthma symptoms and attacks / flare ups continue despite good adherence and correct inhaler technique with high dose inhaled preventers; this is called severe asthma.

Severe Treatment-Refractory Asthma

A smaller number of the severe asthma patients are unable to control their asthma, despite good adherence and correct inhaler technique while taking high levels of inhaled medications and sometimes oral corticosteroids.

People with severe asthma have asthma symptoms most of the time. The disease causes frequent flare ups / attacks requiring oral steroids and may cause severe airway limitation causing constant shortness of breath. People with severe treatment refractory asthma have frequent hospitalisations sometimes requiring intensive care management (Chung et al. 2014).

Asthma Control

Asthma control includes two components: symptom control, and the patient’s risk of flare-ups and other asthma problems.

Asthma Symptom Control

The table below highlights differences between good and poor symptom control. Factors are usually assessed over the previous 4 weeks. Information about asthma control questionnaires are available under Diagnosis & Assessment – Questionnaires.

Good symptom control Poor symptom control
Daytime symptoms ≤2 days per week Daytime symptoms >2 days per week
Need for reliever ≤2 days per week Need for reliever >2 days per week
No limitation of activities Any limitation of activities
No symptoms during night or on waking Any symptoms during night or on waking
  • Discuss asthma symptom control with the patient – For most people with asthma, when they take inhaled medications correctly, their asthma symptoms are kept under control. However, for people with severe asthma, it is important to indicate that symptoms may remain despite adherence medication and the importance of continuing to take medications and regular review.
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Last Updated on February 11, 2019

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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
For considerations relevant to the paediatric and adolescent population, please see Management in Paediatrics or Asthma in the Adolescent Population

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