What are the best ways to diagnose and manage asthma?

A team of experts from The University of Texas Medical Branch at Galveston examined the current information available from many different sources on diagnosing and managing mild to moderate asthma in adults and summarized them. They determined that essential, effective treatment must involve a physical and breathing exam, a comprehensive health history of the patient and ask questions that may answer what triggers may cause an asthma attack. The findings are now available in JAMA.

Asthma affects nearly 8 percent of adults and leads to 1.8 million hospitalizations and 10.5 million visits to the health care provider's office each year in the U.S.

"When a patient comes in who may have asthma, it's important for providers to learn their health history, conduct a spirometry breathing test and a physical exam," said senior author Dr. William Calhoun, UTMB professor in the department of internal medicine, pulmonary critical care and sleep medicine division. "Once diagnosed, the provider should give the patient a questionnaire during each office visit to learn more about how well their asthma symptoms are controlled and how good they perceive their quality of life. Spirometry testing should be repeated every one to two years if the patient's symptoms haven't changed."

Chest imaging may be useful in diagnosing asthma in certain situations, including when the patient has a medically important smoking history or occupational chemical exposure, has long standing disease or mat be at risk for chronic obstructive lung disease or lung cancer.

"The goals of asthma treatment are to reduce the patient's symptoms, help ensure that they can maintain their normal activities, perform well on pulmonary function tests and minimize asthma associated risks such as future asthma attacks and medication side effects," said Jennifer McCracken, UTMB assistant professor in the department of internal medicine, division of allergy and immunology. "Because of the complex nature of asthma, providers need to approach patients with a guideline-based plan that takes environmental triggers such as allergens, viruses and occupational irritants into consideration as well the strengths and weaknesses of the medication that they are using in order to provide a well-tailored action plan."

The study authors noted that a key part of asthma management is a written asthma action plan that details the signs and symptoms of worsening asthma and the steps needed to combat it in layman's terms.

There are both short-acting and long-lasting asthma medications. For quick relief of symptoms, it's important for all asthma patients to have short acting inhalers readily available. These inhalers alone are appropriate for patients who only have periodic asthma. For patients with more constant asthma, longer-lasting daily maintenance controller medications are commonly prescribed in addition to short acting inhalers.