What are the key elements of a thorough assessment in suspected or diagnosed asthma?

Updated: Jan 07, 2019
  • Author: Michael J Morris, MD, FACP, FCCP; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Answer

A detailed assessment of the medical history should address the following:

  • Whether symptoms are attributable to asthma

  • Whether findings support the likelihood of asthma (eg, family history)

  • Asthma severity

  • Identification of possible precipitating factors

Family history may be pertinent for asthma, allergy, sinusitis, rhinitis, eczema, and nasal polyps. The social history may include home characteristics, smoking, workplace or school characteristics, educational level, employment, social support, factors that may contribute to nonadherence of asthma medications, and illicit drug use.

The patient’s exacerbation history is important with respect to the following:

  • Usual prodromal signs or symptoms

  • Rapidity of onset

  • Associated illnesses

  • Number in the last year

  • Need for emergency department visits, hospitalizations, ICU admissions, intubations

  • Missed days from work or school or activity limitation

The patient’s perception of his or her asthma is important regarding knowledge of asthma and treatment, use of medications, coping mechanisms, family support, and economic resources.


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