Asthma treatment: 3 steps to better asthma control

Follow this three-step approach to keep asthma symptoms under control and prevent asthma attacks.

By Mayo Clinic Staff

The goals of asthma treatment are to limit symptoms, prevent asthma attacks and avoid side effects of asthma medicines. The following three steps can help you take control of your asthma treatment.

1. Follow your asthma action plan

Your health care team may work with you to create a written asthma action plan. This plan tells you how to make decisions every day and when to take your medicines. Following this plan is key to controlling your asthma.

A plan has three parts with color codes:

  • Green. The green zone of the plan is for times you are feeling well and have no asthma symptoms. The plan tells you what dose of long-term control medicine to take every day. It also tells you how many puffs of a quick-relief inhaler to take before you exercise.
  • Yellow. The yellow zone tells you what to do if you have symptoms. It explains when to use a quick-relief inhaler and how many puffs to take. It also describes what to do if your symptoms don't improve and when to call your care team.
  • Red. The red zone tells you when to get emergency care if symptoms don't improve or if they worsen.

2. Use at-home lung tests

Your health care team may ask you to use a device that measures how well your lungs are working. This is called a lung function test.

Your asthma action plan includes instructions for when or how often you should do a lung function test. The plan also tells you what to do if the test shows your lungs aren't working well.

You may use one of these devices:

  • Peak flow meter. This device measures how quickly you can force air out of your lungs. Peak flow readings are usually a percentage of how your lungs work at their best. This is called your personal best peak flow.
  • Spirometer. A spirometer measures how much air your lungs can hold and how quickly you can breathe out. This measurement is called forced expiratory volume (FEV-1). Your FEV-1 measurement is compared with the typical FEV-1 for people who don't have asthma. As with your peak flow reading, this comparison is often given as a percentage.

    Your health care team will likely use this test during your office visits, but you may need to use a hand-held spirometer at home.

3. Keep an asthma diary

Keep an asthma diary every day. This information helps you keep track of your symptoms and helps you share accurate information with your health care team. Record the following information:

  • Dose of long-term and quick-relief medicines you use each day.
  • Description of symptoms.
  • Severity and duration of symptoms.
  • Time of day when symptoms occur.
  • Possible triggers of symptoms, such as exercise or allergies.
  • Difficulty with work, school, exercise or other day-to-day activities because of asthma symptoms.
  • Results of a lung function test.
  • Unscheduled appointments or urgent care for asthma.

Symptoms to record in your asthma diary include:

  • Shortness of breath or coughing.
  • Whistling sounds when you exhale, called wheezing.
  • Disturbed sleep caused by shortness of breath, coughing or wheezing.
  • Chest tightness or pain.
  • Hay fever symptoms such as sneezing and runny nose.

Work with your health care team

You will likely meet with your care team regularly for checkups to see how you are doing. Bring your written asthma action plan and your asthma diary to every appointment. The information in your diary helps your asthma specialist know if your asthma is well controlled, poorly controlled or very poorly controlled.

Levels of asthma control in people 12 and older

Well controlled Poorly controlled Very poorly controlled
Symptoms such as coughing, wheezing or shortness of breath 2 days a week or fewer 1 to 3 times a week 4 times a week or more
Nighttime awakenings 2 times a month or fewer 1 to 3 times a week 4 times a week or more
Effect on daily activities None Some limits Extremely limiting
Quick-relief inhaler use to control symptoms 2 days a week or fewer More than 2 days a week Several times a day
Lung test readings More than 80% of your predicted personal best 60% to 80% of your predicted personal best Less than 60% of your predicted personal best

If your asthma is well controlled, your provider may lower the dose of your medicines. If your asthma is poorly controlled or very poorly controlled, you may need to take different medicines or higher doses of medicine. These changes are recorded in your new asthma action plan.

You also may need to take steps to control triggers, such as increasing or changing allergy treatments. You may need to take steps to remove or avoid asthma triggers.

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Aug. 17, 2023 See more In-depth