Abstract
When a patient is newly diagnosed as having asthma, he or she is often prescribed new medication without getting much information on the disease and its treatment. This article emphasizes the need to educate asthmatics. Asthma treatment should begin with a proper adjustment of the medication, allowing asthmatics to lead a normal life. All asthmatics should be shown how to use their inhalation device properly. They should he knowledgeable about the basic aspects of asthma, airway inflammation and bronchoconstriction, use or medication and early symptoms heralding an asthma attack. Environmental factors that may trigger an asthma attack should be explained. Patients should be able to self-monitor asthma using either symptom severity or a peak flow meter. Because asthma is an unpredictable disease, patients should have a self-action plan to implement when their asthma deteriorates.
Highlights
Wh,'.n a patil'nt is nl'wly diagm1sl'd as having asthma, he or shl' is of'ten presnibcd new mediu1tion without ge tting much information on thl' discasL' and its trL'atme nt
Retrospective studies on patients who died from status asthmaticus have shown that about 80% of those deaths could have been pre venteu hy impro v(·cl knowled ge of the di sease hy hoth the p;.itient and the medical personne l (2-'.1)
If peak expiratory flow rates (PEFR ) are measured, they should ideally show a less than 15% diurnal Cluctuation and optimal PEFR at 80 to 85 % of the best value measured
Summary
Peak flow meters are partirnlarly use ful in the subgroup of asthmatics who poorly perce ive the severity of airflow obstruction [24,25] These patients usually present with minimal asthma symptoms while spirometry shows a forced exp iratory volume in I s (FEY 1) that can be as low as 50% of the predicted value. After five days or treatment , the circadia n PEFR variation was closL' to IYk and the patient no lun ge r needed to use the hronchoclilator morni ng and eve ning Because her asthma was stable at the follow-up visit, the action pl ;rn shown in Tahk I was explained to Mrs X. An action plan based on symptoms can be set up as shown in Tabk 2
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