Components of control | Classification of asthma control (5 to 11 years of age) |
Well controlled | Not well controlled | Very poorly controlled |
Impairment | Symptoms | ≤2 days/week, but not more than once on each day | >2 days/week or multiple times on ≤2 days/week | Throughout the day |
Nighttime awakenings | ≤1 time/month | ≥2 times/month | ≥2 times/week |
Interference with normal activity | None | Some limitation | Extremely limited |
Short-acting beta2 agonist use for symptom control (not prevention of EIB) | ≤2 days/week | >2 days/week | Several times per day |
Lung function |
- FEV1 or peak flow
- FEV1/FVC
| - >80% predicted/personal best
- >80%
| - 60 to 80% predicted/personal best
- 75 to 80%
| - <60% predicted/personal best
- <75%
|
Risk | Exacerbations requiring oral systemic glucocorticoids | 0 to 1/year | ≥2/year (see footnote) |
Consider severity and interval since last exacerbation |
Reduction in lung growth | Evaluation requires long-term follow-up |
Treatment-related adverse effects | Medication side effects can vary in intensity from none to very troublesome and worrisome. The level of intensity does not correlate to specific levels of control but should be considered in the overall assessment of risk. |
Recommended action for treatment | - Maintain current step.
- Regular follow-up every 1 to 6 months.
- Consider step down if well controlled for at least 3 months.
| - Step up at least 1 step and
- Reevaluate in 2 to 6 weeks.
- For side effects, consider alternative treatment options.
| - Consider short course of oral systemic glucocorticoids,
- Step up 1 to 2 steps, and
- Reevaluate in 2 weeks.
- For side effects, consider alternative treatment options.
|