Asthma guidelines recommend routine evaluation of asthma control, which includes measurements of impairment and risk. It is unclear whether rigorous asthma control changes risk of asthma morbidity (although it usually does). Kwong and coworkers examined whether the degree of asthma control in inner-city asthmatic children resulted in differential risk reduction of future asthma-related morbidity. The retrospective observational study examined 960 inner-city children with asthma who were highly engaged in an asthma-specific disease management program for a minimum of 2 years. Degree of asthma control was determined during the first year of enrollment and was categorized as well controlled (> or = 80% of visits in control), moderately controlled (50%-79% of visits in control), or poorly controlled (< 50% of visits in control). Risk and probability of asthma-related morbidity at each visit were determined during the second year of enrollment, and included self-reported asthma exacerbations requiring systemic corticosteroid rescue and emergency department visits or hospitalizations. Increasing the degree of asthma control measured during the first year of enrollment led to statistically significant incremental reductions in risk of acute asthma exacerbations and emergency department visits or hospitalizations during the second year of enrollment.

WHAT THE STUDY MAY MEAN TO YOU AS A HEALTH CARE PROVIDER: The authors concluded that achieving and maintaining asthma control in inner-city children with asthma results in significant reductions in asthma-related morbidity. Systematic assessment of asthma control may be useful for predicting future risk in children with asthma.

WHAT THE STUDY MAY MEAN TO YOU AS A PATIENT: If you can achieve and maintain control over your asthma, you are apt to experience better breathing, taking fewer medications, and experiencing a higher quality of life. This what self-management programs for all patients with asthma are imperative. However, these programs alone will not insure control over your asthma: you must continue to perform the self-management skills to achieve this goal.

KY Kwong et al. Asthma control and future asthma-related morbidity in inner-city asthmatic children. Annals of Allergy, Asthma, & Immunology, 2008;101:144-152.