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Guide to Asthma Management | Pharmacy QI | May 2021

May 2021 | Practical Tips for Quality Improvement | View PDF

  1. Treatment of asthma with SABA alone is no longer recommended.
  2. For mild asthma, treatment with as-needed ICS-formoterol reduces the risk of severe
    exacerbations by about two-thirds compared to treatment with SABA only.
  3. Treatment with regular daily low-dose ICS, with as-needed SABA, is highly effective in
    reducing asthma symptoms and exacerbations, hospitalizations, and death.
  4. Step-down treatment once good asthma control has been achieved and maintained for three months.
  5. If resident has persistent, uncontrolled symptoms despite two to three months of controller treatment, assess for:
    • Incorrect inhaler technique
    • Poor adherence
    • Persistent exposure to triggers (e.g., allergens, tobacco smoke, medications such as beta-blockers or NSAIDs)
    • Comorbidities that may contribute to respiratory symptoms and poor quality of life
    • Incorrect diagnosis


Reference:

  1. Global Initiative for Asthma (GINA). Global strategy for asthma management and prevention. 2020 Update. https://ginasthma.org/wp-content/uploads/2020/04/GINA-2020-full-report_-final-_wms.pdf. Accessed March 28, 2021.
  2. Yang CL, Hicks EA, Mitchell P, et al. 2021 Canadian Thoracic Society Guideline – A focused update of the management of very mild and mild asthma. Can J Resp, Critical Care, and Sleep Med. https://cts-sct.ca/wp-content/uploads/2021/02/FINAL-CTS_Very-Mild-and-Mild-Asthma-CPG.pdf. Accessed March 28, 2021.

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