Since a doctor will initiate treatment based on the severity of your asthma at diagnosis, they will assess and classify the severity of your asthma according to the latest guidelines for the management of asthma in adults and adolescents (2007), or the latest guidelines for children (2009).
Attacks typically episodic
Asthma severity is assessed only at the first consultation to decide which initial treatment to start, but after this the doctor will use a similar system (see below) to assess asthma control in order to guide decisions to either maintain or adjust therapy, i.e. to step it up if necessary, or down if possible.
The assessment of severity is used as a starting point to assign a child to a particular treatment group. This assessment is performed between acute episodes in a patient who is not receiving long-term therapy. Assessment of severity depends on the frequency of symptoms and the peak flow reading obtained (the latter in children five years and older).
Symptoms are divided into day- and night-time symptoms (essentially cough and wheeze). Asthma attacks are typically episodic. The intervals between the attacks may be days, months or even years. For severe asthmatics, however, attacks can take place on a daily basis.
Grade one is the mildest grade (known as mild intermittent asthma) and grade four the most severe. Grades two, three and four are classified as chronic or persistent asthma. The doctor will assign you to the most severe grade in which any feature occurs.
Reviewed and updated by Prof Eugene Weinberg, Paediatrician Health24. April 2015
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