Control del asma

CONCISE REVIEW FOR CLINICIANS ATTAINING ASTHMA CONTROL IN 4 EASY STEPS

The ABCs of Asthma Control
BJORG THORSTEINSDOTTIR, MD; GERALD W. VOLCHECK, MD; BO ENEMARK MADSEN, MD; ASHOKAKUMAR M. PATEL,MD; JAMES T. C. LI, MD, PhD; AND KAISER G. LIM, MD
On completion of this article, you should be able to: (1) properly assess impairment using the new asthma guidelines, (2) integrate the AsthmaControl Test questionnaire in routine asthma office visits, and (3) facilitate review of confounding factors and comorbidities of uncontrolled asthma using the mnemonic AIRESMOG.
The new asthma guidelineshave introduced impairment and risk assessments into the management of asthma. Impairment assessment is based on symptom frequency and pulmonary function, whereas risk assessment is based onexacerbation frequency and severity. These 2 measures determine the initial severity of asthma in the untreated patient as well as the degree of control in asthma once treatment has been initiated. The focuson asthma control is important because the attainment of control correlates with a better quality of life and reduction in health care use. We describe 4 easy steps to achieving asthma control in theambulatory practice setting: (1) a standardized assessment of asthma symptoms using a 5-question assessment tool called the Asthma Control Test, (2) a simple mnemonic that provides a systematic reviewof the comorbidities and clinical variables that contribute to uncontrolled asthma, (3) directed patient education, and (4) a schedule for ongoing care. Most if not all patients can achieve goodcontrol of their asthma with optimal care through an active partnership with their health care professionals.

Mayo Clin Proc. 2008;83(7):814-820

ACT = Asthma Control Test; GINA = Global Initiativefor Asthma; NAEPP = National Asthma Education and Prevention Program

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he concept of asthma control has assumed center stage in both the new Global Initiative for Asthma (GINA) and National...