Further Thought on the Misperception of “Controlled Asthma”

By Dr. Larry Chiaramonte
Dr. Ehrlich commented recently on the misconceptions patients, parents AND doctors have about when asthma is controlled. This points to the biggest issue in asthma treatment–compliance. Namely, patients think they are better than they are and don’t comply with their treatment as rigorously as they should. Their doctors take them at their word.
Years ago, we would play a guessing game with patients. If they came to see us thinking their asthma was controlled, we would ask them to guess what their peak flows were before we measured them. They were frequently wrong. This was a good way to get them to take their compliance more seriously. And it worked! Over a two-week period, patients developed a much better sense of their level of control, which is why I believe that close monitoring and better exchange of information will ultimately result in better control, gains in patient health, and big savings for the nation’s health care costs. Now we have an additional tool–measuring exhaled nitric oxide, also know as eNO. Too much of it means your lungs are inflamed even without symptoms. At AsthmaAllergiesChildren world headquarters, we call this the Naughty or Nice Machine.