Asthma Guideline Implementation Classifying/Steps of Tx (Newman)

Question 1

visit interval if asthma is not well controlled

Answer 1

2-6 week interval

Question 2

visit interval if asthma is well controlled

Answer 2

3-6 month intervals

Question 3

when to obtain subspecialist consult

Answer 3

0-4 years old and step 3 or higher (maybe step 2)

5 years or older and step 4 care

difficulty in achieving or maintaining asthma control

Question 4

Step 1

Answer 4

SABA prn

Question 5

Step 2

Answer 5

Low dose ICS

Question 6

Step 3

Answer 6

0-4 yrs medium ICS + referral

> 5 yrs low dose ICS + LABA or
medium dose ICS

Question 7

Step 4

Answer 7

MEdium dose ICS + LABA
or
montelukast + referral

Question 8

Step 5

Answer 8

high dose ICS + LABA
or
montelukast + referral

Question 9

Step 6

Answer 9

High dose ICS + LABA
or
Montelukast + OCS + referral

Question 10

Intermittent: Sx

Answer 10

<2 days/week

Question 11

Intermittent: Nighttime awakenings

Answer 11

0 (<4yrs)

<2xmo >5yrs

Question 12

Intermittent: SABA use for symptoms

Answer 12

<2days/week

Question 13

Intermittent: limitation of normal activity

Answer 13

none

Question 14

Intermittent: lung function

Answer 14

FEV1>80%

FEV/FVC 85% (5-11) normal (>12yrs)

Question 15

Intermittent: excerbation requiring OCS

Answer 15

0-1/year

Question 16

Intermittent: recommended step for therapy

Answer 16

Step 1

Question 17

mild: Sx

Answer 17

> 2 days/week

Question 18

Mild: nighttime awakenins

Answer 18

1-2xmo (<4yr)

3-4xmo (>5 yr)

Question 19

mild: SABA use for symtoms

Answer 19

> 2days/week

Question 20

Mild: limitation of normal activity

Answer 20

minor

Question 21

Mild: lung function

Answer 21

FEV1 >80%

FEV1/FVC >85% (5-11) normal (>12)

Question 22

Mild: exacerbations needing OCS

Answer 22

> 2/6mo (0-4yrs)

>2/year (>5yrs)

Question 23

Mild: recommended step for therapy

Answer 23

Step 2

Question 24

Moderate: Sx

Answer 24

Daily

Question 25

Moderate: Nighttime awakenings

Answer 25

3-4xmo (<4)

>1x/week (>5)

Question 26

Moderate: SABA use for symptoms

Answer 26

daily

Question 27

Moderate: Limitations of normal activity

Answer 27

some

Question 28

Moderate: Lung Function

Answer 28

FEV1 >60%

FEV1/FVC >75% (5-11) reduced by 5% (>12)

Question 29

Moderate: Exacerbations requiring OCS

Answer 29

> 2/6mo (0-4 yrs)

>2/year (>5 yrs)

Question 30

Moderate: recommended step for initiating therapy

Answer 30

Step 3

Question 31

Severe: Sx

Answer 31

throughout the day

Question 32

Severe: Nighttime awakenings

Answer 32

> 1x/week (<4)

7x/week (>5)

Question 33

Severe: SABA use for symptoms

Answer 33

several times a day

Question 34

Severe: Limitation of normal activity

Answer 34

extreme

Question 35

Severe: Lung function

Answer 35

FEV1 <60%

FEV1/FVC <75% (5-11) reduced by >5% (>12)

Question 36

Severe: Exacerbation requiring OCS

Answer 36

> 2/6mo (0-4 yrs)

>2/year (>5yrs)

Question 37

Severe: Recommended step for initiating therapy

Answer 37

Step 3 (<4 yrs)
Step 3 or 4 (5-11 yrs)
Step 4 or 5 (>12 yrs)