Ask the Allergist: Step-Up Care for Asthma
Q: What do asthma patients need to know about the new Asthma Yardstick, and what questions should they ask their doctor?
Bradley Chipps, MD: The Asthma Yardstick came about last year because the U.S. guidelines for asthma care were about 10 years old. And it was increasingly unlikely the federal government would support another guidelines update anytime soon.
With the Asthma Yardstick, we developed a step approach to asthma care, giving doctors recommendations on when to step up asthma care and what medications are appropriate. It uses specific patient profiles that direct doctors and patients to targeted therapy called precision medicine.
Patients can look at specific approaches to asthma care and ask their healthcare provider about whether this treatment plan is the right approach for them. They can learn about the positive aspects of an asthma medication, as well as the side effects of the medicine, and this can all then be applied to their treatment plan.
It’s not likely the average patient is going to read the whole Asthma Yardstick document, but they can look at specific areas of interest to them, including areas they may be considering as an intervention to their current therapy.
Q: Is the Asthma Yardstick for all ages? And is there a step-down approach?
Dr. Chipps: Currently, the adult Asthma Yardstick deals with step-up care for patients who are not well controlled. We do plan a step-down yardstick so when patients are well controlled they can be stepped down in a rational manner.
We expect a pediatric Asthma Yardstick will be published this year. It will give the pediatric community guidelines for children ages 0-5, 5-11 and 12-18. This will allow for appropriate interventions for each range at each step care of asthma.
Bradley Chipps, MD, is President of the American College of Allergy, Asthma and Immunology (ACAAI). He is a board-certified allergist and immunologist and pediatric pulmonologist with Capital Allergy and Respiratory Disease Center in Sacramento, California.
Have a medical question? Email editor@allergyasthmanetwork.org or write to Ask the Allergist, Allergy & Asthma Network, 8229 Boone Blvd., Suite 260, Vienna, VA 22182.