Asthma review

With the right care and medicines most people can keep their asthma under control and live a full and active life. Having an asthma review is an important part of controlling your asthma.

Below are the answers to some of the questions you may have after your recent asthma review.

An asthma review is an appointment with your doctor or asthma nurse to talk about your asthma. It is a time for you both to discuss how you can achieve the best possible control of your symptoms.

You should have an asthma review:

• every year if your symptoms are well controlled or more often if your symptoms are difficult to control. Children should have a review every 6 to 12 months
• a month or so after you have started a new medicine or if your normal medicine has been increased or decreased
• within 48 hours of a serious asthma attack to make sure your symptoms are better controlled. You also need another review one to two weeks after a serious attack to make sure your symptoms are back under control
• if your personal asthma action plan is not helping you to control your symptoms
• whenever you feel that your asthma is not well controlled or if you are unhappy with your medicines.

It is normal for your asthma to be better at some times than others. You will almost certainly find that your asthma symptoms vary. They may be better at certain times of the day, during certain times of the year and even during different times of your life. To help you keep your asthma under good control, you will probably need to alter your medicines as your symptoms change. At an asthma review, your doctor or asthma nurse can check you are taking the right medicines and can advise you about how to make changes to your medicines on your own, within agreed limits.

Your doctor or asthma nurse should also make sure that you are happy with your inhaler/s and check that you are using them correctly.

They will also want to know how your asthma is affecting your life.

An asthma review is a good opportunity for you to ask your doctor or asthma nurse any questions about your asthma that you may want answering. Sometimes it is difficult to know what questions to ask. Asthma UK has provided a list to help you at your asthma review.

Your asthma symptoms may have got worse or better since you last saw your doctor or asthma nurse. When doctors and nurses decide how best to treat your asthma, they should use a nationally agreed ‘stepwise’ approach called the ‘British Guideline on the Management of Asthma’ to help them.

Each step shows what treatment is needed to control your asthma. If the treatment on one step is not working, your doctor or asthma nurse may move your treatment up a step by adding new medicines or by increasing the dose of your current ones. If your asthma is very well controlled you may be able to move down a treatment step so you take fewer medicines or a lower dose of your current ones.

Everyone who has asthma should be offered a written personal asthma action plan. It is a record of the key things you need to know about keeping your asthma under control and should have been completed by your asthma nurse or doctor in discussion with you. It should contain details about your asthma medicines, how to tell when your symptoms are getting worse and what you should do about it. It should also contain emergency information on what to do if you have an asthma attack.

For more information about personal asthma action plans, or to order one, visit the Asthma UK website.

Asthma action plans for young children can be downloaded directly from the Asthma UK website.

Ask yourself these three questions to help you check if your asthma is under control:

In the last month:

• have I had difficulty sleeping because of my asthma symptoms (including cough)?
• have I had my usual asthma symptoms during the day (cough, wheeze, chest tightness or breathlessness)?
• has my asthma interfered with my usual activities – for example doing the housework, going to work or school, or exercising?

If you have answered yes to any of the above questions it may be that your asthma is not controlled as well as it could be.

If your asthma is well controlled you should expect:

• to have very few asthma symptoms
• to be able to take part in all of your usual activities and exercise
• your peak flow readings to be at (or very near) your personal best most of the time.

If your asthma is well controlled you should not:

• need to use your reliever inhaler very often
• have any emergency visits to your hospital or doctor.

If you think your asthma is not as well controlled as it could be, arrange to have another asthma review with your doctor or asthma nurse.

Asthma UK's ‘Be In Control’ pack has been created to help you keep your asthma under control. The pack contains a personal asthma action plan, a peak flow diary, an asthma medicine card and a leaflet called ‘Making the most of your asthma review’. You can order the 'Be in Control' pack online.

The Asthma UK website has lots of information about asthma.

Asthma UK has lots of information to help you manage your asthma that you can order online.

Or speak to Asthma UK’s Support & Information Team, info@asthma.org.uk or call 08456 03 81 43.

You can also talk to an asthma nurse specialist, in confidence, by calling the Asthma UK Adviceline 08457 01 02 03, weekdays 9am to 5pm, calls are charged at a local call rate of 4p per minute.

The Asthma UK Adviceline can be contacted using Typetalk, and an interpreting service is also available if required.

Or if you have a simple question about your asthma, you can send an email to the Asthma UK Adviceline nurses.

If you would like to speak to someone about your asthma face-to-face, make an appointment to have an asthma review with your doctor or asthma nurse. You can also ask your pharmacist if you can discuss your asthma with them next time you are in your pharmacy. They can offer you a Medicines Use Review where you can discuss your medicines and how they work.