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

Overview

Home Management Overview
Asthma Management

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.

Managing Asthma

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.

Key Points

  • Managing patients with severe asthma involves addressing their asthma control, medication management, including add-on therapies, and managing treatable factors
  • Managing severe asthma should be approached as a partnership between the patient, the severe asthma multidisciplinary team, and their general practitioner
  • Optimising individuals’ self-management skills, reviewing and reinforcing these skills regularly, and supporting this with an individualised asthma action plan are important and necessary components of management.
  • Sub-optimal adherence to regular asthma therapies is a serious problem in severe asthma. Improved communication and concordance of the patient’s and clinician’s expectations and understanding will allow this to be identified and addressed.
  • Assessing and managing the multiple comorbidities that occur in severe asthma is needed.
  • Children and adolescents with severe asthma have specific needs. For more information see Paediatric Management.

Self-Management Skills

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.

Asthma Education

Written Action Plans

Adherence

Inhaler Technique

Physical Activity

Interdisciplinary Approach & Multidisciplinary Assessment: Learn more here
Read more

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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