When establishing a treatment plan for your asthma, health professionals refer to the asthma management guidelines developed by The National Heart, Lung, and Blood Institute. The Institute recently updated the guidelines, which are separated into three age group categories: age 0-4, age 5-11, and age 12 and older, including adults¹. What is important for you to know about these guidelines?

Asthma severity and control
For the first time since the guidelines were initiated in 1991, they distinguish between classifying asthma severity and monitoring asthma control. Doctors need to assess the severity of your asthma in order to determine if you need medication and what type of medication you need. The guidelines classify the severity of asthma as intermittent or persistent. If you have persistent asthma (89% of people with asthma do), inhaled corticosteroids remain the preferred long-term treatment for all ages.

Asthma "control" is the degree to which goals of therapy are met. By assessing your level of asthma control, doctors can determine if your medication treatment plan needs to be adjusted. Your asthma is well controlled if you have symptoms less than three days a week, you are not awakened by your asthma more than two times per month,* and you don’t experience any interference with your normal activities. Likewise, your asthma is not in control if you have symptoms more than two days a week, you are awakened by your asthma between one and three times a week,** and you have some limitation of your normal activities.

Questions to discuss with your doctor
To determine your level of asthma severity and control, you and your doctor should be talking about these important questions:

• How many times per week are you bothered by asthma symptoms?
• How many times per month are you waking up with asthma symptoms?
• Does your asthma interfere with your normal activities?
• How often are you using your short-acting beta2-agonist (albuterol, ProAir, Maxair, Ventolin, Proventil, Xopenex)?
• Am I due for a spirometry test (a breathing test to measure your lung function)?

Work together with your doctor to develop or adjust your asthma treatment plan so you can achieve the goal of being well controlled.

* more than once per month for kids under age 12
** more than once per month for kids ages 0-4 and more than twice per month for kids ages 5-11

1 National Asthma Education and Prevention Program Expert Panel Report 3, Guidelines for the Diagnosis
and Management of Asthma, National Heart, Lung, and Blood Institute, Summary Report 2007