Asthma treatment: 3 steps to better asthma control

Asthma treatment is tailored for each person and can change over time. Everyone who has the condition can benefit from asthma treatment to relieve tight, inflamed airways. But asthma triggers, severity and exact symptoms are different for each person — and so is the best asthma treatment plan. You'll need to work closely with your doctor to develop a written asthma treatment plan that's right for you. Follow your treatment plan, and adopt these three key steps to help you get better control of your asthma.

1. Track your symptoms

Record your peak flow measurements and your symptoms in a diary every day. Always take the diary with you when you go to the doctor, so you can review it together and make any needed changes to your asthma treatment plan. Keep an asthma diary to record:

• Increased shortness of breath or wheezing — a whistling sound when you exhale
• Disturbed sleep caused by shortness of breath, coughing or wheezing
• Chest tightness or pain
• Quick-relief (rescue) inhaler use, including when you need to use your inhaler and how many puffs you take
• Decreased productivity at work, school or home due to asthma symptoms
• Increased asthma symptoms during exercise
• Anything that seems to trigger asthma flare-ups, such as secondhand tobacco smoke or pollution

2. Check your lung function

Lung function tests can help determine your level of asthma control. Decreased lung function is a sign you need to adjust your medications according to your treatment plan. If you're following your treatment plan but still have decreased lung function, work with your doctor to adjust your medications. There are two primary lung function tests:

• Peak flow. By learning how to use a simple, hand-held device called a peak flow meter, you can detect subtle changes in your airways before you notice symptoms. A peak flow meter can be used at home to measure how well you can breathe. Peak expiratory flow (PEF) is the reading that indicates the fastest rate at which you force air out of your lungs. If your PEF readings are lower than usual, it's a sign your asthma may be about to flare up. Your doctor can give you instructions on how to deal with low readings as part of your asthma treatment plan.
• Spirometery. Spirometery tests are lung function (pulmonary) tests done at your doctor's office with a machine called a spirometer. Some people also use a hand-held spirometer to take measurements at home. Spirometry tests measure how much air your lungs can hold and how much air you can exhale after you've taken a deep breath. This measurement is called forced expiratory volume (FEV). Your doctor compares your FEV measurement with the predicted result for people who don't have asthma. This comparison is expressed as a percentage. Lower percentages mean your lungs aren't working as well as they should be, a sign your asthma is flaring up.

3. Adjust your treatment

By tracking your symptoms and following your asthma treatment plan, you can identify when you need to adjust your medications to prevent or treat an asthma flare-up.

• Quick-relief inhalers. Most people with asthma need to use quick-relief (rescue) inhalers from time to time. These inhalers contain a short-acting bronchodilator such as albuterol. They quickly open up your airways and make breathing easier. If you have mild asthma or asthma triggered by exercise, you may need to use your inhaler on a regular basis — especially before you exercise. Make sure you know how to use your inhaler properly. It won't keep your asthma under control if you don't use it correctly. When asthma symptoms are bad, you may need to use your quick-relief inhaler more often. Frequent use of a quick-relief inhaler to treat flare-ups is a sign of poorly controlled asthma.
• Long-term control medications. If you have persistent asthma, you will probably also need to take long-term control medications such as inhaled corticosteroids. These preventive medications treat the airway inflammation that causes asthma signs and symptoms. Taken on a daily basis, these medications can reduce or eliminate asthma flare-ups — and your need to use a quick-relief inhaler.

If you follow your asthma treatment plan, but you're still having bothersome symptoms, see your doctor. You may need to increase or change your medication. On the other hand, if your asthma is well controlled all the time, you may be able to reduce the amount of medication you take. This is known as the "stepwise" approach to asthma control. For some people with seasonal allergy triggers, medication may need to be "stepped up" or "stepped down" at certain times of the year.

Levels of asthma control

Even if you have severe asthma, the right treatment can minimize your symptoms. For most people, well-controlled asthma means few symptoms and no interference with normal activities, including sleep, work and school. If your asthma isn't well controlled, see your doctor. Use the chart below to help you determine if you're doing a good job of keeping your asthma under control.

Levels of asthma control in children over 12 and adults