3: Asthma control focuses on two domains: (1) reducing impairment—the frequency and intensity of symptoms and functional limitations currently or recently experienced by a patient; and (2) reducing risk—the likelihood of future asthma attacks, progressive decline in lung function (or, for children, reduced lung growth), or medication side effects. There are six steps to the stepwise approach that consist of first prescribing a SABA as needed which is the only treatment needed in this step, but for those that that have mild or persistent asthma, the patient should also take a low-dose ICS daily. Steps two through six recommend utilizing daily 3
Asthma and Stepwise Management medications at varying doses dependent upon the severity of the disease process. The NAEPP EPR-3 recommend the medications should be prescribed as follows: step two should be prescribed a low-dose corticosteroid, step three should receive a medium-dose ICS or low-dose LABA including ICS, step four requires LABA and medium-dose ICS, step five will receive a LABA and a hig-dose ICS, and step six will be prescribed an oral corticosteroid in conjunction with a LABA and a high-dose ICS. Stepwise Management Assisting Providers and Patients Through the guidance of the stepwise program, providers and patients will benefit from the best treatment protocols set up for asthma care and maintenance. With the aid of the program, all parties will have knowledge of each stage of the disease process with guidelines for medication regimens and alternative therapies that can be utilized for the best case scenario. Controlling exposure to irritants and harmful inhalants, managing comorbidities, maintaining the medication regime, and patient education are all part of the stepwise program to garner the best possible treatment plan for each asthmatic patient.
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- Summer '15
- stepwise management