Bronchial asthma (BA) is a disease that is well understood. Science knows the causes, mechanisms of development, and approaches to achieving bronchial asthma control. However, statistics show that only one patient in four has the disease under control.
At the same time, bronchial asthma control is the main indicator when it comes to the effectiveness of therapy, and includes such characteristics as:
severity of symptoms;
frequency of exacerbations;
frequency of emergency care;
the need for medications to control the symptoms of the disease;
Every patient with diagnosed bronchial asthma is familiar with its symptoms: wheezing; feeling of stuffiness in the chest; choking; dry, with difficult to separate sputum, compulsive cough, including at night.
Depending on the frequency of symptoms, several levels of AD control are distinguished. Thus, in well-controlled asthma, attacks and the need for the use of drugs to control them occur in the patient no more than 2 times a week, the patient, the patient does not wake up at night and he does not have limited physical activity. In partially controlled AD, daytime symptoms recur more frequently than 2 times a week, so there is a need for a rapid-relief inhaler, and patients wake up at night because of attacks. Uncontrolled asthma can be considered when the frequency of symptoms and the need to control them is more than twice a week, the patient experiences physical activity limitations and has to wake up at night because of asthma symptoms.
Need for quick-relief medications
Another marker of uncontrolled AD is the need for symptom control medications (called short-acting bronchodilators or rapid-relief inhalers). The short-acting drug relieves symptoms, creating the illusion that all is well, although in fact the cause of the disease (inflammation) remains. As a result, the patient is caught in a vicious circle: symptoms occur more often and the need for bronchodilators increases.
Revision of therapy may be necessary if:
You use your inhaler to control asthma attacks 3 times a week or more or use up 12 inhalers (bottles) a year (if you have this situation, do not wait for your next routine doctor’s consultation, make an appointment to assess the course of bronchial asthma).
What to do next:
Keep track of how often you use a rapid-relief** inhaler to control your bronchial asthma attacks. The main purpose of prescribing a new drug for regular bronchial asthma therapy is to reduce the severity of your asthma symptoms and therefore reduce the need to use a rapid-relief inhaler. If you are taking a new drug for regular therapy of AD, but still need to use an inhaler for symptomatic therapy 3 or more times a week, you may need to make a follow-up appointment with your doctor.
Controlling future risks
Bronchial asthma control is not only the absence or minimal severity of symptoms, but also “reducing the potential risk associated with worsening of the condition, development of exacerbations, disease progression, and manifestation of medication side effects”. Accordingly, achieving good clinical control of bronchial asthma can reduce the risk of exacerbations.
It should be remembered that provoking factors, or so-called triggers, play an important role in the development of exacerbations. Some of them are independent of the patient. For example, comorbidities. Others can be controlled by the patient.
The patient must necessarily master the correct inhalation technique, as the effectiveness of therapy depends on it.
Another important condition for controlling bronchial asthma is the fulfillment of doctor’s prescriptions. Bronchial asthma is a variable disease, that is, its symptoms are not always pronounced: a person may feel fine, but this does not mean that the disease does not exist. That is why no self-medication or self-cancellation of medications is out of the question.
In addition, for the control of bronchial asthma, external influences that can cause its exacerbation (allergens, stressful situations, etc.) are of great importance. Therefore, the patient’s task is to do everything possible to minimize their influence, and thus reduce the risk of an attack.