Sometimes life just feels turbulent--and our asthma journey can feel that way as well. In a recent sit down with my specialist, we looked at the plot/graph of my asthma journey. The graph looked specifically at responses to particular treatments. This had me reflecting on how do we define success in asthma treatment as patients?
The goal of asthma treatment has been identified as:1
- A decrease in symptom burden. These may be identified as daily symptoms and activity limitations.
- Minimizing the risk of adverse outcomes. We can think of these as exacerbations, lung function changes and treatment side effects.
Asthma treatment goals: clinical vs patient
It is important to remember that clinical goals may differ from individual patient goals and patients should speak to their clinician and care team about their specific goals. This is an area that delights and frustrates patients. Asthma treatment should have a personalized approach, however, not every patient has these experiences. The patient voice needs to be heard and understood. If you are presented with something that does not feel clear, or your care team presents a goal that you don’t agree with, ask for clarification, reconsideration, or make your case heard.
Components of asthma treatment include the following:1
- Asthma education
- Ensuring that you have an action plan
- Inhaler training
- Symptom control
- Pharmacological treatment
- Treating comorbidities
- Managing side effects
As many patients know, asthma treatment is a series of assessments and reassessments. These can be your usual spirometry, ACQ, and/or symptom review by your care team, and any self-monitoring that you may do. It is the day-to-day monitoring that has me thinking about our successes and wins.
Positive and negative changes
When I was looking at my treatment and responses chart with my physician, I was both happy to have made progress and a bit saddened that there had been some less positive changes. I had been on a mostly good streak, but have had some flares that I learned may be connected to a different autoimmune process. Researchers are learning more about this, but there are not many answers at this stage.
Overall, I am not circling the drain. I am not requiring a significant amount of rescue medication and I still have a mixed relationship with my eosinophilia and daily oral corticosteroids need. This will remain a top goal and indicator of success in my asthma management and treatment. If I do not need daily oral corticosteroids that would be the pinnacle of success for me. I also would like to be able to maintain good asthma control for hopefully a lifetime, without daily oral corticosteroids.
Focusing on my treatment successes
In the interim, I am charting a new course, by focusing on how my successful asthma management is getting me a step closer to doing all the things I would like to do, one day I will travel again (COVID-19 responses) more than anything to do with my asthma and I will do my dream cycling trip in northern Japan. I will be able to train for it because I have good asthma control. The better controlled my asthma, the more of the things that I would like to do, I will be able to do. This will also include finding ways to deal with health setbacks.
How do you determine if your asthma treatment goals were successful? Does it differ from your physicians’? What is your top indicator? I would love to hear your experiences and thoughts.
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