Historical |
Poor symptom control over the past 4 weeks |
≥1 exacerbations in the previous year |
Prior intensive care unit admission and/or endotracheal intubation for asthma |
Comorbid diseases |
Obesity |
Chronic obstructive pulmonary disease |
Chronic rhinosinusitis (particularly with nasal polyposis) |
Uncontrolled allergic rhinitis |
Gastroesophageal reflux disease |
Aspirin-exacerbated respiratory disease |
IgE-mediated food allergies |
Pregnancy |
Anxiety |
Depression |
Medication-associated |
Poor adherence to prescribed anti-inflammatory therapies (eg, inhaled glucocorticoids, ICS-LABA, anti-leukotrienes) |
Incorrect inhaler technique or difficulty with administration |
High SABA use (especially >200-doses per month or three 200-dose canisters per year) |
Exposures/triggers |
Smoking |
Second-hand smoke exposure |
Allergen exposure (if sensitized) |
Respiratory viral infections |
Air pollution |
Excess heat or cold exposures |
Recurrent exposure to airborne irritants |
Cocaine or heroin use (especially when inhaled) |
Diagnostic testing |
Impaired lung function (especially FEV1 <60% predicted) |
High reversibility (FEV1 improvement by >15%) on post-bronchodilator spirometry |
Elevated type 2 inflammatory markers* despite medium- to high-dose ICS-LABA |
Access to care |
Difficulty affording asthma therapies |
Lack of insurance or other difficulty obtaining regular follow-up |
FEV1: forced expiratory volume in one second; ICS-LABA: inhaled corticosteroids-long-acting beta-agonist; IgE: immunoglobulin E; SABA: short-acting beta-agonist.
* Sputum/blood eosinophilia, fraction of exhaled nitric oxide (FeNO).Do you want to add Medilib to your home screen?