Asthma control

The term ‘asthma control’ often has a different meaning for patients compared with its medical meaning. People with severe asthma in this study expressed what asthma control means to them, how they get their asthma under control, and how it feels emotionally if their asthma is not controlled. The most common response was that asthma control means being able to do the things they want to do—often what other people consider ‘normal activity’—and not be limited by symptoms. They spoke about being able to manage daily living, being on top of things and have a regular routine with no crises when their asthma is controlled. For Jemma controlling the asthma was about the ability to play and compete in international sport. For others, having their asthma controlled was essential if they were to consider travelling. Others equated control with an absence of infection, not needing to take oral steroids or seeing the specialist less often.

For John B control means doing everything he wants to do.

Joel feels things are controlled most of the time

For Allen asthma control is a matter of life and death

To healthcare providers good asthma control has two domains: it means good asthma symptom control, i.e. no limitation of activities, no symptoms during the night or on waking, daytime symptoms no more than 2 days per week, and no need for reliever more than 2 days per week, as well as having few or no flare-ups and no or minimal side-effects of treatment. However people living with severe asthma often experience poor symptom control, multiple flare ups and frequent need for steroid tablets despite being treated with what is considered optimal therapy [Reference: Upham and Chung].

During periods of good symptom control, people we interviewed said they tended to forget about the possibility of attacks. They also feared the uncertainty that comes with going from a stable situation to worsening asthma, not knowing if and when a severe attack might happen.

Marion explains about the uncertainty of life moving forward.

Methods used by people in our study to feel that they had their asthma under control and keep it that way included constant vigilance, good preparation and planning—which involved avoiding triggers and risky situations, having a written asthma action plan and taking their preventer medication. They didn’t see that they had a choice about taking medication if they wanted to keep their asthma under control.

Tony is always prepared.

After one bad episode Mick is vigilant and uses an asthma action plan.

Denise doesn’t see any choice but to have asthma under control.

Despite their best efforts, not everyone felt they were able to keep their asthma under control, and this led to feelings of fear and depression, and that the asthma was controlling them.

Kim feels she has no control over her asthma

Karen has been unable to control her asthma since the onset of a viral infection.

Shannon finds the lack of control scary.

References:

  1. Upham JW, Chung LP. Optimising treatment for severe asthma. Med J Aust 2018; 209 (2): S22-S27.