New concepts in treatment of chronic persistent asthma. Using a stepwise protocol to control inflammation

Asthma continues to cause unacceptably high rates of disability and death, largely because the severity of disease is underestimated and patients are inadequately educated about their disease. When patients understand what happens during an asthma attack and its aftermath, they are more likely to notice important symptoms and to start or increase self-treatment appropriately. Physicians are responsible for teaching patients how to avoid precipitating factors and for discussing and writing down a self-treatment plan to follow in specific circumstances. The British Thoracic Society has suggested a stepwise protocol for drug treatment of asthma. Each patient must be evaluated individually and started at the appropriate step.