What are the signs asthma is poorly controlled?

Updated: Oct 07, 2019
  • Author: John J Oppenheimer, MD; Chief Editor: Michael A Kaliner, MD  more...
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Indications of very poorly controlled asthma include the following:

  • Symptoms throughout the day

  • Nighttime awakenings ≥4 times per week

  • Short-acting beta-agonist use (rescue) several times per day

  • Extreme limitation in normal activity

  • FEV1 or peak flow < 60% predicted/personal best

  • Two or more exacerbations requiring oral systemic corticosteroids per year

Recommended actions when asthma is under very poor control include considering a short course of oral systemic corticosteroids, stepping up 1-2 steps, reevaluating the patient in 2 weeks, and considering alternative treatment options if adverse effects occur with therapy.

In 2-6 weeks, in poorly controlled cases, evaluate the level of asthma control that has been achieved and adjust therapy accordingly. Review adherence to medications, inhaler technique, environmental control, and comorbid conditions. A progressive loss of lung function and the adverse effects of medication should also be included in the overall assessment of risk.

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