Asthma management in adolescents and adults

In this episode, Dr Stephen Child discusses the NZ Asthma and Respiratory Foundation's 2020 adult and adolescent guidelines.

Topics

Major changes to asthma guidelines.
Asthma control test.
Reliever therapy.
Exercise-induced asthma.
Maintenance therapy.
Stepwise approach.
When to refer.

Take home messages

Short-acting beta-agonist use is a sign of poor control and increased use may be a sign of worsening asthma. SABA use along now is not recommended- if your patient is using SABA alone this is a sign of failure of your management.
Never use unopposed LABA therapy- they always must be used in combination with an inhaled corticosteroid.
The Asthma control test (ACT)- is an important tool to measure control. You need to remember not just to treat the symptoms, but the inflammation which is the underlying pathophysiology.
Revisit your diagnosis treatment failure- Is this really asthma? Treat the treatable traits and look for underlying reasons for exacerbations.
After the acute management of an exacerbation- step up and treat for at least 6 months.

Resources

The pharmacological management of asthma in adolescents and adults has changed bpacnz (2020)
Respiratory Guidelines Asthma and Respiratory Foundation NZ
Anti-inflammatory reliever (AIR) therapy for mild asthma Goodfellow MedCase (2020)

Presenter

Stephen Child

General Physician

Contact here

Dr Stephen Child is a Canadian-trained General Physician with a respiratory medicine interest who moved to his current role as General Physician at Auckland District Health Board (ADHB) in 1994. Clinically, he has an interest in asthma and general internal medicine with a strong passion for medical education.