Is your doctor following national guidelines for your asthma care?

If not, you could be missing out!

For the past 20 years, there have been guidelines for the diagnosis and treatment of asthma published through a multi-disciplinary group at the NHLBI (National Heart Lung & Blood Institute) of the NIH (National Institutes of Health). The most recent “update” was published in 2007 and is called EPR-3 (Expert Panel Report) and found at: http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.pdf

Although there is a need for another revision, some doctors who treat asthma patients are unfamiliar with these guidelines. Over 10% of doctors don’t even know the guidelines exist. Many who are aware of the guidelines don’t follow them because they disagree with them, don’t think the guidelines improve care or feel it takes too much time to follow the guidelines. For pediatricians, self-reported adherence to the asthma guidelines was between 39% and 53%. This can be problematic when most asthma begins in childhood. Studies have shown an under use of written asthma action plans, lack of scheduling follow-up visits and under utilization of spirometry (lung function testing). Even if a healthcare provider is familiar with and agrees with clinical practice guidelines, they have limited effect on changing physician’s behavior. I think it is called inertia…I’ve done it this way for years and I won’t or can’t change!

The guidelines give recommendations (from evidence-based medical studies and expert opinion when data is lacking) to assist doctors in diagnosing and treating asthma. Specifically, the guidelines were developed to bridge the gap between current knowledge and practice.

Does following the asthma guidelines improve care and the outcomes of patients?

• Yes, ER visits, hospitalizations and rescue medication use decreases significantly.

The most recent asthma guidelines provide direction so patients with asthma will:

Reduce impairment

• Less daytime symptoms (less than once a week)

• Less night-time symptoms (less than once a month): sleep is good

• Normal activity: exercise and sports are important

• Normal lung function: it is best to be breathing with both lungs at 100%. It makes life easier and more fun!

Reduce risk

• Prevent recurrent asthma attacks. Asthma attacks can be scary!

• Reduce need for oral steroids like Prednisone (once a YEAR is max). That’s good; oral steroids can have severe side effects.

• Minimize Emergency Room visits and hospitalizations. Nobody really wants to be there if they don’t have to and it is expensive.

• Prevent remodeling (permanent scarring in the small airways in the lungs). Our lungs ever so gradually lose function as we age beyond 20 years old. This decrease is faster in people with asthma and even faster in people with asthma who smoke.

At Family Allergy Asthma & Sinus Care, we are familiar with and follow national guidelines for the diagnosis and treatment of asthma. At the same time, it is important to realize that these are only GUIDELINES and that each patient requires specific individual treatment approach that best suits them. For this reason, patients with asthma benefit from the experience and knowledge of a specialist who treats asthma.