Ongoing management of asthma in children

Once asthma is stable and well controlled, and the minimum regimen has been established, 3- to 6-monthly review is sufficient.

At each review:

• assess symptom control
• check adherence and inhaler technique (see Summary of inhalational drug delivery devices for links to patient handouts and videos demonstrating inhaler technique)
• reiterate advice about avoiding asthma triggers and maintaining a healthy lifestyle and up-to-date immunisations
• assess and manage comorbid conditions that can worsen asthma control (eg allergic rhinitis)
• ensure the written asthma action plan is up to date and the child (and their parents or carers) understand how to use it
• provide advice and education to facilitate supported self-management.

A more detailed assessment including spirometry should be performed if the patient’s symptoms have changed or if the diagnosis is uncertain.