Assessment of asthma control in adults

This case is not an uncommon presentation of someone with asthma in primary care. It highlights a number of pertinent issues regarding the assessment of asthma control. Importantly, the patient perceives her condition as well controlled despite frequent symptoms and the need for daily reliever medication, which from a medical perspective are features of poorly controlled asthma. Furthermore, the patient is not taking a regular preventer medication, she has suffered from a recent exacerbation, has low lung function, and is a smoker, all of which lead to an increased likelihood of future exacerbations. This future risk is another important component of the assessment of the patient’s asthma control. Finally, there are other issues that will also need to be addressed as part of the assessment of her asthma control, including her increasing weight and her sedentary lifestyle. Obese patients with asthma may experience suboptimal control of their symptoms despite improvements in their spirometry and airway inflammation.