Initiating therapy and severity control

 

initateasthma

 

adjustasthma

STEP DOWN Therapy:

  • when well-controlled for at least 3 months
  • Never during acute illness

 

STEP UP Therapy:

  • Find asthma is not well-controlled AND rule out other possible causes of poor control: medication non-adherence, poor inhaler technique, poor environmental control, comorbidities
  • If adverse effects impact use/adherence and consequently asthma control, consider alternate options for drug therapy
  • Re-evaluate patient in 2-6 weeks (depending on assessed control, e.g., very poorly 2 week follow up) to achieve control
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