Asthma that is not well controlled can have a number of consequences. Uncontrolled asthma can make it difficult to keep up with day-to-day responsibilities, including work and relationships, as well as take a toll on your physical and emotional health. According to a report published by a task force for the American Academy of Allergy, Asthma, and Immunology (ACAAI), asthma is well controlled when:
- You experience asthma symptoms two times a week or fewer
- You use your rescue inhaler two times a week or fewer
- You do not experience nocturnal asthma symptoms or asthma symptoms early in the morning
- Your asthma does not interfere with everyday life or exercise
- Lung function tests (measured using a peak flow meter or spirometer) are at or above normal
Below, we look at a few common reasons that asthma may not be under control.
Not following a treatment plan
Research shows that many patients with uncontrolled asthma do not adhere to their treatment plan. If your asthma symptoms are not well controlled, check that you are taking your treatment as directed. If you have a problem taking your treatment as directed—for example, if you experience side effects or can’t afford the cost of your treatment—talk to your healthcare provider to come up with a solution.
Improper inhaler technique
Inhalers are the most common delivery method for asthma medicine, but studies have found that many patients with asthma and other respiratory diseases do not use inhalers correctly. You should take your inhaler to every appointment so that your healthcare provider can confirm you are using the right technique, and help you correct your technique if necessary.
Exposure to triggers
Recognizing and avoiding asthma triggers is a key component of managing asthma. Even if you're adhering to your treatment, if you're continually being exposed to a trigger or triggers, your asthma may not be under control. Evaluate your home and work environments to look for culprits that could be exacerbating your symptoms and talk to your healthcare provider about ways to avoid exposure.
Other health conditions
You could be dealing with symptoms of another health condition in addition to asthma, such as COPD, vocal cord dysfunction, GERD or aspirin-exacerbated respiratory disease. See your healthcare provider for a thorough evaluation and to rule out other potential causes of persistent symptoms.
Severe asthma
Between 5 and 10 percent of asthma patients have severe asthma, where asthma symptoms are not well controlled, even after treatment and addressing the factors listed above. Severe asthma is treated with long-term control medicines, high-dose inhaled corticosteroids and biologic therapies (also called immunomodulators), medicines that target inflammatory processes in the body that are linked to asthma. Some patients may also require surgery to treat severe asthma.
If your asthma symptoms persist despite following your treatment plan, it is important to work with your healthcare provider—and keep working with your healthcare provider—to find an effective treatment plan. It also helps to educate yourself about asthma and how asthma can be treated and controlled.
