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Feature Article

The variability of asthma and how to respond to it

Christine Jenkins

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An updated version is available in the linked supplement

Abstract

Asthma, by its very nature, is a variable disease, and this makes it particularly challenging to manage for both patients and clinicians.

Key Points

  • Asthma is associated with variability in several domains, including symptoms experienced, disease pattern over time, degree of airway obstruction, response to treatment, triggers causing symptoms, and prognosis.
  • The variability of asthma makes it a particularly challenging disease to manage for both patients and clinicians.
  • It is essential that patients recognise that typically asthma has a variable pattern and long symptom-free intervals usually do not mean the disease is cured.
  • The use of standard questions and a peak flow record can help clinicians understand the degree to which patients are sensitive to, or apparently unaware of, the variability of asthma.
  • Optimal asthma control takes months or even years to achieve in some patients. Fine tuning of medications, identification of triggers, provision of a written action plan and facilitation of self-management education are all crucial in achieving this.

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