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Practical guidance on the recognition of uncontrolled asthma and its management

Hoy, Haley M. PhD, ACNP1,a; O'Keefe, Louise C. PhD, CRNP1,b

Journal of the American Association of Nurse Practitioners: August 2015 - Volume 27 - Issue 8 - p 466–475
doi: 10.1002/2327-6924.12284

Purpose: To highlight the significance of asthma in primary care and offer a practitioner-friendly interpretation of the asthma guidelines for the busy provider, while introducing new treatment options currently in clinical trials, such as the once-daily long-acting anticholinergic bronchodilator tiotropium Respimat.

Data sources: Articles with relevant adult data published between 2004 and 2015 were identified via PubMed. Additional references were obtained by reviewing bibliographies from selected articles.

Conclusions: In the United States, uncontrolled or symptomatic asthma is common, with rates of 46%–78% in primary care. Uncontrolled asthma has a substantial impact on patients’ quality of life and represents a significant healthcare burden. Nurse practitioners can improve patients’ asthma control through education, monitoring, assessment, and treatment. Although asthma management guidelines are readily available, the authors recognize that nurse practitioners see patients with multiple comorbidities, all of which have treatment guidelines of their own.

Implications for practice: Nurse practitioners have a compelling opportunity as frontline caregivers and patient educators to recognize and assess uncontrolled asthma, along with determining the steps necessary to help patients gain and maintain symptom control.

1 College of Nursing, University of Alabama in Huntsville, Huntsville, Alabama,

Received 3 December 2014; Accepted 12 May 2015

Correspondence Haley M. Hoy, PhD, ACNP, College of Nursing, University of Alabama in Huntsville, 301 Sparkman Drive, Huntsville, AL 35899. Tel: 1-256-824-6669; Fax: 1-256-824-6026; E-mail:

Grant sponsor: Boehringer Ingelheim.

Disclosure Each author meets the criteria for authorship as recommended by the International Committee of Medical Journal Editors. The authors take full responsibility for the scope, direction, and content of the article and have approved the submitted article. The authors received no compensation related to the development of the article.

Funding This review was commissioned by Boehringer Ingelheim, who also supported the publication costs for this article. The authors have not received any honorarium in relation to this article.

a(Interim Associate Dean)

b(Assistant Professor)

© 2015 American Association of Nurse Practitioners
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