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Despite the development and availability of new treatments and prescription medications, asthma remains a widespread chronic health problem in the United States. Achieving asthma control in patients is a resource-intensive enterprise that requires close assessment and personalized management. Asthma is simply not a disease that can be remedied with prescription medications alone. In 2007, the National Asthma Education and Prevention Program released their Guidelines for the Diagnosis and Management of Asthma. The guidelines provide assistance and direction to health care professionals in the assessment and treatment of patients with asthma. Two cases are presented to illustrate the treatment process in light of the Guidelines and the outcomes of these patients, who have varying degrees of support, education, and assessment of adherence to an asthma treatment plan. J Am Osteopath Assoc. 2014;114(11 suppl 3):eS4-eS15 doi:10.7556/jaoa.2014.165

Much clinically significant data are available from research performed by the Asthma Clinical Research Network and these data should affect the way that physicians treat patients with asthma.

Inhaled corticosteroids are the mainstay of asthma therapy; however, inhaled long-acting β2-agonists (LABAs) are frequently used in the treatment of patients with asthma. LABAs are combined with high-dose inhaled corticosteroids (ICSs) for patients with severe persistent asthma, and they are combined with low-dose ICSs for patients older than 5 years with moderate persistent asthma. Recent safety concerns raised by data from the Salmeterol Multi-Center Research Trial (SMART) have indicated that use of LABAs in some populations may contribute to increased mortality. These concerns are warranted when LABAs are used as monotherapy in the treatment of patients with asthma in whom they may cause increased exacerbations, blunting of rescue-medication effect, and worsening symptoms. However, when used in combination with an ICS, they decrease both rescue-medication use and symptoms, increase lung function, and act as steroid-sparing agents.