NIH sets new goals for control of asthma
Better day-to-day treatment is urged
WASHINGTON -- Breathing easier without limiting activities is the goal of new government guidelines that urge more attention to asthma sufferers' day-to-day symptoms, not just their severe attacks.
Some 22 million Americans have asthma, and guidelines updated yesterday by the National Institutes of Health stress the importance of adjusting therapy until their asthma is well under control.
"Asthma control is achievable for nearly every patient," said Dr. Elizabeth Nabel, director of NIH's National Heart, Lung and Blood Institute. "Patients really should accept nothing less."
The guidelines reflect a shift already underway, as specialists seek to teach patients that a flare-up isn't the only sign of trouble. Someone who avoids an attack only by giving up exercise, or who thinks it's normal to wake up at night coughing or to wheeze while running, doesn't have asthma well-controlled.
And the recommendations are being made at a key time: Asthma hospitalizations peak in September and October, said Dr. Homer Boushey of the University of California, San Francisco, a guideline coauthor.
Asthma is a chronic lung disease caused by inflammation inside airways that in turn makes them supersensitive, narrowing in response to irritants that wouldn't bother a healthy lung. Symptoms include wheezing, coughing, chest tightness, and difficulty breathing.
There is no cure, but daily medications are very effective at reducing inflammation and preventing flare-ups. Yet asthma kills about 4,000 people a year and causes almost half a million hospitalizations.
The guidelines are aimed at doctors, but include some patient-friendly advice:
Give your doctor details about day-to-day symptoms and whether you've adjusted activities to avoid wheezing, to help him or her monitor current impairment and future risk of a severe attack.
Patients need a written "action plan" with instructions for daily treatment and what to do if their asthma worsens. Share that plan with teachers and coaches.
Inhaled corticosteroids are the foundation of preventive treatment for all ages. Patients also need inhaled rescue medication.
Children ages 5 to 11 usually do well on low doses of a single drug, the inhaled corticosteroid, instead of the combination treatments required by many adults.
