Experts Release New Asthma Care Guidelines

Experts Release New Asthma Care Guidelines
MONDAY, Nov. 12 (HealthDay News) -- Asthma control and prevention ofattacks are the focus of new national asthma guidelines released by theU.S. National Heart, Lung, and Blood Institute's National Asthma Educationand Prevention Program (NAEPP).
The 23 million Americans -- including 6.5 million children -- withasthma can avoid serious symptoms and disability if they follow theselatest guidelines to keep their asthma under control, said the experts whowrote the guidelines.
"Asthma is not an event, it is a chronic disease that can be managed sothat symptoms are controlled and severe attacks are prevented," Dr.Michael B. Foggs, chief of asthma, allergy and immunology at AdvocateHealth Care in Chicago, said in a prepared statement. "The guidelinesunderscore the fact that people who are diagnosed with asthma do not haveto suffer breathing difficulties or cut back on their activities. We wantto make this a reality for all asthma patients."
The guidelines place a new emphasis on doctor-patient partnerships andongoing asthma monitoring and management. Among the specificrecommendations:
All patients with asthma should be monitored by a doctor every one tosix months, regardless of how severe their condition is and whether theyare experiencing symptoms.Every patient should have a written asthma action plan withinstructions for daily treatment and what to do if symptoms become worse.The action plan should be developed by a doctor or a nurse, with inputfrom the patient, and shared with all those who interact with the patient,such as family members, teachers and coaches.Asthma care should include education that takes into account apatient's cultural background and literacy level. Patients should play anactive role in managing their asthma.Asthma treatment based on severity is now classified in six steps,rather than the four steps used in previous guidelines. A stepwiseapproach is still recommended, with medication increased when asthmasymptoms worsen and decreased, if possible, when asthma is undercontrol.
"When patients and physicians work together to follow these guidelines,asthma symptoms can be prevented, and patients can participate in allactivities and not miss days of work or school because of asthma. No oneshould expect anything less," Foggs said.
The new guidelines -- the first major update in a decade -- alsohighlight the routine use of inhaled corticosteroids as the standard ofcare for most patients with chronic persistent asthma.
"Low- to medium-dose inhaled corticosteroids are very safe and remainthe first line of treatment for preventing asthma symptoms. Unfortunately,they are not prescribed as often as they should be," H. William Kelly,professor emeritus, department of pediatrics, University of New MexicoHealth Sciences, Albuquerque, said in a prepared statement.
"Some people confuse these safe medications with the risky anabolicsteroids used by some athletes to improve performance. When usedappropriately, corticosteroids are safe and effective in controllingasthma," Kelly said.
Based on research suggesting that children ages 5 to 11 may respondsomewhat differently to medications than adults, children in this agegroup were singled out as a separate category by the guidelineauthors.
For many children ages 5 to 11, asthma can be controlled with a lowdaily dose of inhaled corticosteroid, rather than combination treatments,such as long-acting beta agonists, required by many adult asthmapatients.
The guidelines also stress the need for patients to take theircontroller medications even when they don't have asthma symptoms. Patientsalso need to be taught how to use inhalers properly so the medicationreaches their lungs.
The new guidelines were to be presented Sunday at the annual meeting ofthe American College of Allergy, Asthma and Immunology, in Dallas.