Key questions to ask when taking the medical history of a patient with asthma or suspected asthma

Key questions to ask when taking the medical history of a patient with asthma or suspected asthma

1. Asthma symptoms: cough, wheeze, increased work of breathing/shortness of breath, chest tightness?

2. Age of onset of symptoms?

3. Timing of symptoms: day vs. night?

4. Is there a change of symptoms during a specific season during the year?

5. Possible triggers: viral infections, dust, animal exposures, pollen, strong smells, tobacco smoke, emotion?

6. Severity of symptoms - often reflected by unscheduled physician appointments at a walk-in clinic, urgent care or emergency room, hospital admissions, and need for rescue oral corticosteroids?

7. Past tests: including chest X-rays (CXR), spirometry, allergy tests (skin test or blood test)?

8. Other associated conditions (co-morbidities): allergic rhinitis, eczema, food allergy, insect venom allergy?

9. Current and past treatments for asthma (names of inhalers)? Duration of use, how long did you take the medications for? Reasons for stopping the medication?

10. Barriers to treatment: expensive medication, low availability of health care providers?

11. Exposure to second- and third-hand tobacco smoke: lingering smell of tobacco smoke on clothing or in vehicles?

12. Presence of household pets?

13. Impact of the symptoms on the patient/family quality of life: missed time from activities, school or work due to asthma symptoms?

How to know if your asthma is controlled

1. No exacerbations (flare ups) of symptoms.

2. Fewer than 3 doses per week of a rapid-acting beta2-agonist bronchodilator, such as albuterol.

3. Daytime symptoms fewer than 3 days per week.

4. No nighttime symptoms.

5. Normal physical activity.

6. No absent days from work or school due to asthma symptoms.

7. Ling tests such as FEV1 or PEF at least 90% of personal best.

References:

Asthma, Practical guide for allergy and immunology in Canada 2018 https://buff.ly/2CXsbwf