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Managing asthma patients: which outcomes matter?

A. P. Greening^*, D. Stempel^#,¶, E. D. Bateman and J. C. Virchow

^* Respiratory Unit, Western General Hospital, Lothian University Hospitals Division and University of Edinburgh, Edinburgh, UK, ^# Infomed Northwest, Bellevue, ^¶ University of Washington, Seattle, WA, USA, Division of Pulmonology, Dept of Medicine, University of Cape Town, Cape Town, South Africa, Dept of Pneumology, University Medical Clinic, University of Rostock, Germany.

CORRESPONDENCE: A. P. Greening, Respiratory Unit, Western General Hospital, Lothian University Hospitals Division and University of Edinburgh, Crewe Road South, Edinburgh, EH4 2XU, UK. Fax: 44 1315371038. E-mail: a.greening{at}ed.ac.uk

Within the respiratory specialist community, there is growing recognition that classification of asthma based on severity of symptoms alone may not accurately reflect the clinical status of a patient. It follows, therefore, that treatment decisions based on this classification can lead to suboptimal management of asthma.

The concept of assessing patients by their level of asthma control is gaining wide acceptance and is a major component of the new 2006 Global Initiative for Asthma guidelines. Questions remain, however, on how best to achieve and maintain asthma control.

Randomised controlled trials have shown that very good asthma control is achievable in the majority of patients. There is a need for a tool to accurately assess a patient's level of control in the clinical setting if such results are to be replicated in practice.

A symposium at the European Respiratory Society Annual Congress in 2006 discussed the important issues that are currently facing asthma clinicians. The current article summarises the main points arising from that symposium.

KEYWORDS: Asthma, asthma control test, classification, control, combination therapy, management