Treatment and Management of Asthma Using the Stepwise Approach

Asthma and Stepwise Management
Asthma is a common disorder that affects around 1 in 13 Americans today (Asthma facts and figures, 2018). Although there is no cure for asthma, the condition can be managed effectively using various methods, including most especially a stepwise approach. The purpose of this paper is to provide a description of long-term control and quick relief treatment options for asthma sufferers and side effects such interventions can cause. In addition, an explanation concerning the stepwise approach to asthma treatment and management and how stepwise management assists health care providers and patients in gaining and maintaining control of the disease is followed by a summary of the research and key findings concerning asthma treatment and management in the conclusion.
Long-term control and quick relief treatment options for asthma patients, as well as the impact these drugs might have on patients
The long-term treatment options for asthma are intended to reduce the inflammation of the airway and reduce the frequency and severity of asthma symptoms while quick-relief treatment options such as inhaled short-acting beta2-agonists are intended to relieve the symptoms of asthma as they occur (Asthma treatment, 2018). According to the National Heart, Lung, and Blood Institute, “Inhaled corticosteroids are the preferred medicine for long-term control of asthma. They're the most effective option for long-term relief of the inflammation and swelling that makes airways sensitive to certain inhaled substances” (Asthma symptoms, 2018, para. 5). In addition, other pharmacological interventions that are commonly used for long-term asthma treatment include Cromolyn in the form of a nebulizer and Omalizumab (anti-IgE) (Asthma symptoms, 2018).
The stepwise approach to asthma treatment and management
While a number of different strategies are available for asthma treatment and management, Arcangelo and Peterson (2013) maintain that the stepwise approach provides the optimal clinical outcomes. A general stepwise approach to asthma treatment and management for patients aged 12 years and over is set forth in Table 1 below.
Table 1
Stepwise approach to asthma treatment and management
Step 1
Step 2
Step 3
Step 4
Step 5
Step 6

Use of a short-acting
beta-agonist
(e.g., albuterol prn)
If used more than 2
days per week
(other than for
exercise) consider
inadequate control
and the need to
step up treatment.
Low-dose
inhaled steroid or leukotriene
blocker or
cromolyn
Low-dose
inhaled steroid +
long-acting beta
agonist or
Medium-dose
inhaled steroid
Medium-dose
inhaled steroid +
long-acting beta
agonist
High-dose
inhaled steroid +
long-acting beta
agonist
—and—
Consider
omaluzimab
if allergies
High-dose
inhaled steroid +
long-acting beta
agonist + oral
steroid
—and—
Consider
omaluzimab
if allergies



Source: Adapted from Stepwise Approach to Managing Asthma (2018)
How stepwise management assists health care providers and patients in gaining and maintaining control of the disease
The stepwise management approach provides clinicians with the ability to monitor the efficacy of interventions and make changes in medication dosage or lifestyles when needed. In addition, current clinical guidelines place a priority on asthma control evaluation (Gurkova & Popelkova, 2016). In this context, Gurkova and Popelkova (2016) report that, “Asthma control is generally considered to reflect disease activity as captured by punctuations in symptoms and the degree to which these symptoms limit activities, disturb sleep or require the use of a rescue inhaler” (p. 287). If a rescue inhaler is used more frequently than prescribed, however, it may signal the need for increased dosages of prescribed long-term medications.
Conclusion
Although millions of Americans of all ages suffer from asthma and the disorder has no cure, the condition can be treated effectively using various management strategies. The research showed that the stepwise management approach for asthma is widely regarded as providing optimal clinical outcomes for patients. Finally, the research also showed that gaining control over asthma is a treatment priority since this will help reduce the frequency and severity of associated asthma symptoms.

References
Arcangelo, V. P., & Peterson, A. M. (Eds.). (2013). Pharmacotherapeutics for advanced practice: A practical approach. Ambler, PA: Lippincott Williams & Wilkins.
Asthma facts and figures. (2018). Asthma and Allergy Foundation of America. Retrieved from http://www.aafa.org/page/asthma-facts.aspx.
Asthma treatment. (2018). National Heart, Lung, and Blood Institute. Retrieved from https://www.nhlbi.nih.gov/node/3894.
Stepwise approach to managing asthma. (2018). Asthma Initiative for Healthy Lungs. Retrieved from http://getasthmahelp.org/documents/gist-stepwise-approach.pdf