Standard requirements for asthma control - GINA 2006
NEW ASTHMA CRITERIA
Currently, the basic criterion is the severity of asthma
The severity of asthma or the severity of the disease is assessed by two types of measures:
1. Symptomatic measures - referring to the observation and sensation of the severity of asthma by patients and their doctors
2. Objective measures - referring to an objective measurement of the air flow rate through the respiratory tract using special diagnostic devices.
[Symptoms of the severity of asthma]
Symptomatic measures are characterized by complaints experienced by the patient and observable: wheezing, stumping, coughing, feeling of breathlessness and heaviness in the chest, etc. They are subjective or difficult to measure. We assess them using such indicators as: the volume of symptoms, their intensity (intensity), perceived nuisance and slightly objectified - such as the duration of a given symptom or its frequency in a time unit (eg frequency of cough reflexes per minute), etc.
Objective measures of asthma severity
These meters are based on the measurement of the airflow rate through the airways. Speed of so-called Exhalation flow is measured by a special technical device - a peak flow meter (measurement in the so-called PEF flow rate units) or a spirometer (measured in more complex FEV1 units). These tests are often carried out allowing the patient's objective and precise self-control of asthma.
New criteria
The new measures stress not the "severity" - but the degree of achieving the goal of treatment!
In this sense, they are the opposite to the defensive, scale-based "health damage" of the 4-point "severity of asthma" scale.
Benchmark criteria for achieving treatment goals:
- no asthma symptoms throughout the day
- no exercise restriction
- normal lung function (according to PEF and / or FEV1)
- no nocturnal awakening due to asthma and nocturnal asthmatic symptoms
- no asthma exacerbations
- no need to use emergency bronchodilators (rescue medication used no more than twice a week)
Depending on the achievement of the above mentioned goals of treatment - it stands out:
Measurement of treatment effectiveness by new criteria
A / Failure to achieve one or two of the above treatment goals qualifies asthma for so-called the level of partially controlled disease.
B / Failure to meet three or more of the above criteria for good asthma control and each week with exacerbation of symptoms - means a complete lack of disease control, i.e. uncontrolled asthma.
Diary of self-control
This is a recommended notebook in which the occurrence and characteristics of asthma symptoms, the consumption of drugs and the effectiveness of self-control are recorded, i.e. the results of home PEF measurements.
On this basis, a properly educated patient can modify the set and doses of drugs on a regular basis and therapeutically "overtake" symptoms of exacerbations of asthma - reducing their severity and ailment.
RECOMMENDATION OF RECOGNITION OF THE REASONS OF DISEASE
Typical causes of asthma exacerbations are:
- atopy - strong sensitization to allergens (genetically determined)
- individually differentiated response to stimuli that cause asthma symptoms: stress, physical effort, low temperature, etc.
- diseases that exacerbate and aggravate the severity of asthma symptoms - viral infections (influenza, cold, etc.)
- other individual factors
It is particularly important to reduce the exposure to allergens
In the case of atopy and atopic asthma, try to reduce the exposure to allergens, which can be achieved by at least two methods:
- desensitization to these allergens that aggravate the symptoms of the disease to which vaccines are available
- avoidance of exposure to allergens, if technically and financially possible (avoidance of sensitizing animals, change of residence, occupation in the case of allergies to the work environment, air filters, climate trips, etc.)
Expect medical help
Identifying risk factors and developing an optimal method of responding to their effects is a joint task of the doctor and the patient.
Ed. RED.
Literature:
1. The fight for full control of asthma - Author: prof. Piotr Kuna, Dr. Izabela Kupryś-Lipińska, Clinical Hospital N. Barlickiego, Medical University of Lodz. Clinic of Internal Diseases, Asthma and Allergy, University
2. Treatment of asthma in adults - Guidelines for the World Asthma Initiative (GINA 2006) based on: Global strategy for asthma management and prevention. Revised 2006
Global Initiative for Astma http://www.ginasthma.org (quoted on 14.12.2006). Created on: 12.03.2007. Medycyna Praktyczna 2007 - www.mp.pl
3. What's new in bronchial asthma? Anna Jassem, Alicja Siemińska, - Doctor's Guide 2/2006
4. Long-acting beta 2-agonists in the treatment of asthma - do not pour the child out of the bath. Droszcz W .: Med. Prakt., 2006; 4: 168-170
