alternative classification of asthma

Introduction

Assessment criteria include:

• 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
• assessment of risk
  • frequency of exacerbations
  • progressive loss of function
  • treatment-related adverse events

Classification

• 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
• 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
• poorly controlled
  • exceeds criteria of not well controlled (any)