Self-Managing Asthma: What You Should Know

In my latest adventure of Finding 9 Issues of the Now Extinct Journal of Asthma and Allergy Educators in my file boxes recently, I’m uncovering a lot of interesting material on what people with asthmashould know, specifically with regard to self-management. Self-management encompasses all of the things we do, outside of a doctor’s office or clinic, to deal with our asthma. Should is italicized for a reason, which is that as patients, we cannot always be expected to simply know things.

Self-management has a lot to do with education

Part of the reason we see health care professionals is to be educated. In the case of doctors, I personally think that our asthma self-management skills should be questioned on a regular basis (a little pop-quiz, if you will). If we’re rusty on a random area they select to ask us about, we should either be educated in-office or sent to an asthma education professional for a refresher.

Instead, I think it’s sometimes assumed we’ll just go home and Google any new questions and go on with our lives. Google is great, with the right sources, but it can only help so much. It can’t tell me if I’m taking my inhaler correctly, if I should try a different medicine, or if my peak flow technique sucks, or what to do, specifically, if I start flaring, or what could be triggering my asthma.

Asthma is a spectrum (and an extremely diverse one at that). Asthma self-management has a lot of different components that will vary greatly from person to person. In addition to simply knowing what asthma is, there are a lot of things that we should know about our asthma, such as: how do we stack up as patients?

Asthma self-management behaviors

The following list is what I, personally, interpreted from my reading of Teaching Patients the Critical Components of Asthma Self-Management to be the “critical components” 1—or, in other words, what’s in your asthma-skills toolbox?

Medication behaviors

  • Taking your long-term control medicines as prescribed
  • Understanding why long-term control medicines are prescribed to be taken continuously
  • Carrying your rescue inhaler all the time
  • Understanding why it is important to carry your inhaler at all times
  • Understanding how each medication you are on works (the basics!)
  • Understanding how each different inhaler type you are prescribed is used properly (ex. technique for pressurized metered dose inhaler vs. dry powder)
  • How to clean your inhalers, spacers, and nebulizers
  • Why it is important to clean your asthma stuff (answer: more effective delivery of meds because they don’t get stuck! Also germs.)
  • Checking dose counters on inhalers, or alternate strategies for dose counting if your inhalers do not have a dose counter.
  • Understanding over-dosing and under-dosing on meds, and why taking the right dose, the right times, the right way matters.1

Monitoring behaviors

  • Check-ins should occur with a health care provider every 1 to 6 months.
  • A written asthma action plan should exist for all patients (specifically with moderate or severe asthma, or a history of prolonged or difficult exacerbations) with instructions for increasing/decreasing medications. Asthma action plans can be either symptom or peak flow based (or a combination)
  • Peak flow technique, if used, should be checked regularly to ensure accurate readings
  • Understanding when and where to access care based on symptoms1

Trigger avoidance behaviors

  • Identify asthma triggers (accurately!), both allergic and non-allergic
  • Strategize for management of triggers (ie. pre-medication for exercise, taking antihistamines for allergies, removal of carpets for dust allergy, etc.) or avoidance of triggers
  • Strategies should be determined for each trigger that an individual experiences.1

Asthma self-management should still have guidance

You’ll notice that many of these are dependent on your asthma care provider—whether that is an asthma educator, a primary care or family physician, or an asthma specialist (pulmonologist). It also depends on how knowledgeable they are on asthma, how engaged they are in your care, and if they ensure you are an engaged team member in your own self-management. For instance, I cannot simply run an allergy test on myself, or be 100% certain without a professional’s feedback that I am doing all of these things correctly… Despite my best intentions!

Do you believe all of these components ARE “critical components”? Do you think anything is missing? How does your knowledge of your own asthma match up? Do you check off all, most, or only a few of the boxes? Sign in and let’s discuss in the comments, below.

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