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alternative classification of asthma
Assessment criteria include:
1) assessment of impairment
- symptom frequency
- frequency of need for short-acting beta-2 agonist (does not include use for prevention of exercise-induced bronchospasm)
- interference with normal activity
- results of validated questionnaires such as ACT
- objective measures FEV1 of peak expiratory flow
2) assessment of risk
- frequency of exacerbations
- progressive loss of function
- treatment-related adverse events
Classification:
1) well controlled (all of the following)
- symptoms occur <= 2 days/week
- use of short-acting beta2 agonist <= 2 days/week
- nocturnal awakenings <= 2/month
- no interference with normal activities
- ACT score >= 20
- FEV1 or peak expiratory flow > 80% of predicted (or personal best)
- <= 1 exacerbation/year
2) not well controlled (any of the following)
- symptoms occur <= 2 days/week, but not throughout the day
- use of short-acting beta2 agonist > 2 days/week, but not several times/day
- >= 3 nocturnal awakenings/month
- some, but limited, interference with normal activities
- ACT score of 16-19
- FEV1 or peak expiratory flow 61-79% of predicted (or personal best)
- 2-3 exacerbations/year
3) poorly controlled
- exceeds criteria of not well controlled (any)
References
- Geriatric Review Syllabus, 7th edition
Parada JT et al (eds)
American Geriatrics Society, 2010