Education And Debate

ABC of Asthma: CHRONIC ASTHMA—GENERAL MANAGEMENT

BMJ 1995; 310 doi: https://doi.org/10.1136/bmj.310.6991.1400 (Published 27 May 1995) Cite this as: BMJ 1995;310:1400
  1. John Rees,
  2. John Price

    General features

    Obvious precipitating factors should be sought and avoided when practicable. This is possible for specific allergens such as animals and foods, but is not usually feasible with more widespread allergens such as pollens and house dust mites. A common non-specific stimulus is cigarette smoking. Up to a fifth of asthmatics continue to smoke andstrenuous efforts should be made to discourage smoking in both asthmatic patients and their families. Precipitating factors should be carefully explored on one of the first visits but they should also be reassessed periodically.

    Fortunately most asthmatic patients can have their disease controlled by safe drug treatment with minimal side effects. Education of the patient in understanding the disease and treatment is often helped by home peak flow recording and written explanations of the purpose and practical details of treatment. In particular, the differences between symptomatic bronchodilator treatment and regular maintenance treatment must be emphasised. It is all too common to find asthmatic patients using their dose of inhaled steroid or sodium cromoglycate only to treat an acute attack. Trained nurses can be helpful in continuing education and supervision.

    Asthma clinics

    Many hospitals have concentrated their patients into specific asthma clinics for …

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