Класифікація засобів контролю астми*,†
Component | Well Controlled | Not Well Controlled | Very Poorly Controlled |
|---|---|---|---|
Symptoms | All ages except children 5–11 years: ≤ 2 days/week Children 5–11 years: ≤ 2 days/week but not > once/day | All ages except children 5–11 years: > 2 days/week Children 5–11 years: > 2 days/week or multiple times on ≤ 2 days/week | For all ages: Throughout the day |
Nighttime awakenings | Adults and children ≥ 12 years: ≤ 2/month Children 5–11 years: ≤ 1 /month Children 0–4 years: ≤ 1/month | Adults and children ≥ 12 years: 1–3/week Children 5–11 years: ≥ 2/month Children 0–4 years: > 1/month | Adults and children ≥ 12 years: ≥ 4/week Children 5–11 years: ≥ 2/week Children 0–4 years: > 1/week |
Interference with normal activity | None | Some limitation | Extreme limitation |
Use of short-acting beta agonist for symptom control (not prevention of exercise-induced asthma) | ≤ 2 days/week | > 2 days/week | Several times/day |
FEV1 or peak flow | > 80% predicted/personal best | 60–80% predicted/personal best | < 60% predicted/personal best |
FEV1/FVC (children 5–11 years) | > 80% | 75–80% | < 75% |
Exacerbations requiring oral systemic corticosteroids‡ | 0–1/year | Adults and children ≥ 5 years: ≥ 2/year Children 0–4 years: 2–3/year | Adults and children ≥ 5 years: ≥ 2/year Children 0–4 years:> 3/year |
Validated questionnaires: | |||
| 0 | 1–2 | 3−4 |
| ≤ 0.75† | ≥ 1.5 | Ν/Α |
| ≥ 20 | 16−19 | ≤ 15 |
Recommended action | Maintain current step Follow up every 1–6 months Consider step down if well controlled for ≥ 3 months | Step up 1 step Reevaluate in 2–6 weeks For adverse effects, consider treatment options | Consider short course of systemic corticosteroids Step up 1 or 2 steps Re-evaluate in 2 weeks For adverse effects, consider treatment options |
* All ages unless specified differently. | |||
† Level of control is based on the most severe impairment or risk category. Additional factors to consider are progressive loss of lung function on pulmonary function tests, significant adverse effects, and severity and interval between exacerbations (ie, one exacerbation requiring intubation or 2 hospitalizations within 1 month may be considered very poor control). | |||
‡ At present, there are inadequate data to correlate frequencies of exacerbations with different levels of asthma control. In general, more frequent and intense exacerbations (eg, requiring urgent, unscheduled care, hospitalization, or intensive care unit admission) indicate poorer asthma control. | |||
ACQ = asthma control questionnaire; ACT = asthma control test; ATAQ = asthma therapy assessment questionnaire; FEV1 = forced expiratory volume in 1 second; FVC = forced vital capacity. | |||
Adapted from National Heart, Lung, and Blood Institute: Expert Panel Report 3: Guidelines for the diagnosis and management of asthma—full report 2007. August 28, 2007. Available at http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm. | |||