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Ann Allergy Asthma Immunol. 2017 Feb;118(2):133-142.e3. doi: 10.1016/j.anai.2016.12.010.

Asthma Yardstick: Practical recommendations for a sustained step-up in asthma therapy for poorly controlled asthma.

Author information

Capital Allergy & Respiratory Disease Center, Sacramento, California. Electronic address:
Section of Clinical Immunology and Allergy, David Geffen School of Medicine at UCLA, Los Angeles, California.
Department of Medicine, Harvard Medical School, and Pulmonary and Critical Care Division, Brigham & Women's Hospital, Boston, Massachusetts.
Cohen Asthma Institute at National Jewish Health, Denver, Colorado.
Department of Allergy and Clinical Immunology, Asthma Center, Respiratory Institute, Cleveland Clinic, Cleveland, Ohio.
Department of Medicine, Robert Wood Johnson Medical School, Rutgers Institute for Translational Medicine & Science, Department of Medicine, University of Pennsylvania, Child Health Institute of New Jersey, and Rutgers, The State University of New Jersey, New Brunswick, New Jersey.
Section on Pulmonary, Critical Care, Allergy & Immunologic Diseases, Department of Internal Medicine, Pediatrics and Translational Science, Center for Genomics and Personalized Medicine Research, Respiratory Service Line, Wake Forest Baptist Health, and Wake Forest School of Medicine, Winston-Salem, North Carolina.
Academic Services Connection Inc, Canandaigua, New York.


Current asthma guidelines recommend a control-based approach to management that involves assessment of impairment and risk followed by implementation of treatment strategies individualized according to the patient's needs and preferences. The fact that many patients still experience severe symptoms that negatively affect quality of life suggests that asthma control remains an objective to be achieved. Tools are available to help patients (and families) manage the day-to-day and short-term variability in asthma symptoms; however, when and how to implement a sustained step-up in therapy is less clear. The Asthma Yardstick is a comprehensive update on how to conduct a sustained step-up in asthma therapy for the patient with not well-controlled or poorly controlled asthma. Patient profiles and step-up strategies are based on current guidelines, newer data, and the authors' combined clinical experience and are intended to provide a practical and clinically meaningful guide toward the goal of well-controlled asthma for every patient. The development of this tool comes in response to the continued need to proactively address the sustained loss of asthma control at all levels of severity.

[Indexed for MEDLINE]

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