Asthma management: a stepwise approach

The November 15th issue of AFP features an updated clinical review of medical therapies for asthma, based on the 2007 Expert Panel Report of the National Asthma Education and Prevention Program (NAEPP). This review recommends a "stepwise approach" for asthma management in patients 12 years and older, depending on the severity of asthma and response to first-line medications. Persons with intermittent symptoms may use an inhaled short-acting beta-agonist as needed; older children and adults with persistent asthma generally require daily inhaled corticosteroids, and possibly additional medications.

Another component of effective management is the use of written asthma action plans for patients to monitor asthma control outside of planned office visits and to take physician-approved steps to address worsening symptoms. The article includes examples of asthma action plans for children and adults, as well as a link to a short video about asthma action plans on Familydoctor.org.

For information about related clinical issues such as the role of allergens in asthma, treatment of asthma in young children, managing acute exacerbations, and practice-level approaches to planned asthma care, you can consult our AFP By Topic collection.