For a patient with exercise-induced asthma who wishes to participate in competitive sports, the primary goal is to achieve complete asthma control, which includes no limitations on activity, including exercise NICE NG245.
A key management strategy involves the use of an anti-inflammatory reliever (AIR) therapy, specifically a low-dose inhaled corticosteroid (ICS)/formoterol combination inhaler, to be taken as needed for symptom relief and before exercise NICE CKS. This approach has been shown to significantly reduce severe asthma exacerbations NICE CKS.
It is crucial to provide the patient with a personalised asthma action plan, which should be reviewed at every asthma-related healthcare attendance and at annual review NICE CKS. This plan should advise on individualised triggers, how to recognise early signs of an asthma exacerbation, and specific instructions on medication adjustments, including when to use oral prednisolone if needed NICE CKS.
Regular physical activity is beneficial for general health and can improve symptoms and quality of life in people with moderate or severe asthma NICE CKS. Therefore, supporting the patient's participation in competitive sports is in line with general health recommendations NICE CKS.
At every asthma review, whether routine or unscheduled, and at every asthma-related consultation, it is essential to observe the patient using their inhaler device to ensure correct technique NICE NG245. Incorrect inhaler technique and poor adherence increase the risk of uncontrolled asthma and future exacerbations NICE CKS.
Monitor asthma control at every review, checking for symptoms, time off work or school due to asthma, amount of reliever inhaler used, number of oral corticosteroid courses, and any hospital admissions or emergency department attendances due to asthma NICE NG245. Consider using a validated symptom questionnaire to assess control NICE NG245.