Asthma is a chronic but treatable disease that causes difficulty breathing because of narrowing of the airways. Asthma affects more than 22 million Americans, including over 6 million children under 18 years old. If not treated properly, asthma can severely limit individuals’ activities. Asthma exacerbations can worsen and lead to hospitalization or even death. The CDC estimates that 4,000 Americans die from asthma each year. The goal of treatment is to control asthma symptoms so that patients can lead full, active lives while minimizing asthma attacks.

A national asthma intervention pilot program last year showed that three-quarters of Americans with asthma did not have their asthma under control. This, in part, has lead the National Asthma Education and Prevention Program (NAEPP) to issue the first comprehensive update to the clinical guidelines for the diagnosis and treatment of asthma in over a decade. The guidelines include an expanded section on childhood asthma, new guidance on medications, new recommendations for patient education beyond the doctor’s office, and new advice on controlling environmental factors that cause asthma symptoms. The guidelines emphasize that while asthma symptoms can be controlled, the condition can change over time and can vary by individual and age group. It is important to monitor regularly the level of asthma control so that treatment can be adjusted.

The guidelines focus on four components of asthma care. These four areas are measures to assess and monitor symptoms, patient education, control of environmental and other factors that worsen asthma, and the use of medications. Changes in assessment and monitoring include multiple measures of the level of impairment and future risk. The guidelines emphasize the importance of teaching patients to self-monitor and manage asthma, including the use of written asthma action plans. Multiple approaches to limit exposure to allergens and other triggers are recommended. The section on other common conditions that worsen asthma has been expanded to include conditions such as overweight, sleep apnea, stress and depression. The guidelines specify the need for individual medication treatment plans and the need to adjust medications by age group, as children respond differently from adults to medications.

One of the core features of the new guidelines is the importance of personalized treatment of asthma based on the individual’s disease characteristics. The NAEPP is developing tools and partnerships to improve adoption of the guidelines by the medical community including the release of a summary report on October 17, 2007.

References: http://public.nhlbi.nih.gov/newsroom/home/GetPressRelease.aspx?id=2442, http://www.nhlbi.nih.gov/guidelines/asthma/index.htm.

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