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.

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

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.

• 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.