Monitoring Asthma

Monitoring the signs and symptoms of asthma on a regular basis will help keep the condition under control. A few tools available for effective monitoring of asthma are discussed below.

Action Plan

Health care providers normally draw an action plan for asthma patients. The action plan outlines what to look out for during physical activity, what can be classified as controlled and uncontrolled asthma, and how to handle any sudden asthma attacks. Such a plan is very useful for people with asthma to make decisions regarding treatments based on the kind of symptoms experienced.

Self-Monitoring - Peak Flow Meter

Based on the severity of asthma in different patients, doctors may recommend use of a self-monitoring device called the peak flow meter. This device helps monitor the change in asthma-related signs and symptoms during the day or over a period of time.

A peak flow meter is a hand-held device that estimates the peak expiratory flow rate. This flow rate is a measure of how fast one can exhale air from your lungs, after a deep inhalation, which demonstrates how well air is moving through the airways. If asthma-related bronchoconstriction is present, peak flow levels will be low. Peak flow measurements at regular intervals help in estimating the level of control of asthma.

Usually, 3 peak flow measurements are made and the best reading is recorded. Measurements can be done before and after reliever drug inhalation. Measurements are recorded once or twice every day to monitor changes in peak flow during the day or over a period of time. A decrease in peak flow measurement over time may indicate worsening of asthma and an increase in peak flow measurement may show increased control of asthma or a response to controller medications inhaled.

Based on the results of peak flow measurements, patients can go back and refer to their asthma action plan and take appropriate action. Health care providers review peak flow measurements at regular intervals and make adjustments to the asthma action plan.

Asthma Diary

Keeping a diary to note down asthma-related details or progress is helpful to keep track of:

• The signs and symptoms of asthma
• Use of different medications, their timings and frequency
• Readings on the peak flow meter
• The allergens or activities that trigger asthma from time to time.

Such a systematic record can be very crucial in asthma management and help doctors adjust treatment plans over time.

Watch Out for Signs

Some of the signs that indicate asthma may be getting worse are as follows:

• Symptoms occur mostly at night, affecting quality of sleep.
• Asthma starts interfering with normal day-to-day activities
• Symptoms become more frequent and more severe
• Low or fluctuating peak flow number
• Symptoms cause absenteeism at school or work
• Increased use of quick-relief inhaler; more than twice a week
• Decreased response to asthma medications

Any of the above signs would mean that the patient needs to see their doctor, who will take stock of the situation and adjust medications and treatment plans to control asthma.

Monitoring of Asthma in Children

Ongoing monitoring of children with asthma is crucial. Thiswill need a careful review of the impact of asthma on the child's day to day activities, such as play or sports. Face-to-face follow-up and standardized questionnaires such as the Asthma Control Questionnaire helps track asthma symptoms and has been found to be effective in the case of children. Parents should keep track of symptoms and notify the child’s physician in case of changes in mood or behavior post administering medications.

References

• https://www.nhlbi.nih.gov/health-pro/resources/lung/naci/discover/asthma-control.htm
• http://www.ncbi.nlm.nih.gov/pubmed/25745042
• http://www.on.lung.ca/page.aspx?pid=408
• http://www.asthma.ca/adults/control/howToMonitor.php