Feature Article

Worsening asthma in adults. Part 1: Preventing exacerbations and developing an action plan

Paul J Hamor, Kwok Yan, Helen Reddel



Despite recent significant advances in the control of asthma, exacerbations still cause significant morbidity and mortality. The first part of this two-part article discusses strategies for the prevention of exacerbations, the early identification of worsening asthma, and patient self-management using a written action plan.

Key Points

  • Ensure patients are taking preventer medication regularly.
  • Check and provide skills training for optimal use of inhaler devices.
  • Identify avoidable patient-specific triggers of worsening asthma.
  • Educate patients to recognise early signs of worsening asthma through self-monitoring of symptoms or objective measures such as peak expiratory flow.
  • Provide a written asthma action plan, tailored to the individual patient, that includes details of preventers and relievers for use when asthma is under control, an escalation plan for when asthma worsens and advice on when to seek medical or emergency care.
  • Review the asthma action plan annually or when maintenance treatment changes.