LAY OVERVIEW
The medical goals of treating someone with severe asthma are to lower their symptom burden and the risk of attacks, as well as to reduce the decline in lung function and treatment side-effects. People with asthma will have their own goals. As essential step in the treatment programme is to develop a partnership between the patient, doctor and health care professionals, to establish each others goals, feelings and worries about asthma and its treatment.
The medical goals of severe asthma treatment are to reduce the burden of symptoms and the risk of adverse outcomes such as flare-ups/lung attacks / exacerbations, decline in lung function and medication side-effects. People with asthma will have their own goals for asthma management. Treatment should start with an empathic discussion between the clinician and individual with asthma about goals, attitudes and concerns about asthma and its treatment. For more information see Living with Severe Asthma.
Optimising a person’s asthma knowledge and self-management skills using a shared decision-making approach and improving adherence by discussing the factors that may be leading to poor adherence to prescribed medications, will improve asthma control and health outcomes.
Patients should be provided with information about severe asthma in combination with an individualised written asthma action plan, instruction on self-monitoring of symptoms (with or without peak expiratory flow (PEF)), and a regular medical review. Inhaler technique should be assessed and optimised regularly. Written asthma action plans are one of the most effective asthma interventions available. If PEF monitoring is used either in assessment or management of asthma, a standardised chart is available for free download to improve interpretation of the results.
Patients should also be encouraged to engage in an active lifestyle, including physical activity and exercise, recognised to facilitate asthma control. Address concerns that patients may have about undertaking physical activity. Emotional aspects should also be discussed, such as discussions of patient concerns and emotions when experiencing an exacerbation or flare-up.
It is important that self-management skills are regularly reviewed, on an annual basis and anytime an exacerbation occurs.
In addition to self-management approaches, it is also important to discuss the patient’s (non-medical) support network in managing their condition. It may be useful to discuss with patients what support they have available.
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