8 Tips to Improve Asthma Control
James Thompson, MD | March 28, 2012
Doctors often have short segments of time (much too short in my opinion) to interview, examine and discuss treatment on follow-up visits which on average are 10 to 20 minute intervals. Many times your doctor has certain benchmarks she/he wants you to achieve (e.g. High peak flow rate or ACT score) but you may have your own desired goals that need to be communicated and addressed. When you and your doctor’s expectations are not well aligned good asthma management may be difficult to achieve. So what can you do?
Keep a record
Get a small spiral notebook or log in order to write down important items of information concerning your asthma care and concerns. If questions regarding your medications or treatment plan arise, in between doctor visits, write them down for future reference. Write down and prioritize your main goals in asthma care to share with your doctor.
Ask about your asthma action plan
Once a year you should discuss your asthma action plan (AAP) with your doctor. Should maintenance medications (controller meds) be increased, lowered or stay at the same dose? Should you follow the same directives when you have an asthma flare-up? Did this plan work well the last time you used it for an asthma flare-up? If not, what should be adjusted? You definitely should have a written AAP.
Have your inhaler technique checked
This can identify any flaws that may have developed. I identify one or more flaws in inhaler 60-80 percent of the time on follow-up visits. Seriously, ask the doctor or nurse to observe how you take your inhaler once or twice a year.
Review your list of indoor triggers
Also take into account previous suggestions on how to reduce exposure to them (pets, dust mites, fumes or fragrances etc.). Is there more you can do?
Ask about recommended vaccinations
Find out when to get them and inquire about other vaccinations. Should you have a pneumonia vaccine?
Ask about allergic rhinitis
If you have allergic or non-allergic rhinitis is it under good control? Ask about how can you improve treatment in order to keep it from worsening asthma control.
Follow-up twice a year
Good asthma management requires follow-up doctor visits and review of treatment parameters at least twice yearly. My well-controlled asthma patients are asked to follow-up with me every six months. Sometimes people think they are doing well but according to breathing tests (spirometry) or asthma control tests (ACT), are not.
See if you have other health risks
Are there other health conditions which may be impacting your asthma control? Are you overweight? Do you snore loudly? Do you have high blood pressure or take medication to treat it? Did you smoke previously? Do you have frequent heartburn? This is an incomplete list, but think about some of these disorders before your appointment.