Defining mild, moderate and severe asthma

How does a patient know what is mild, moderate or severe asthma?
Dr. Shapiro:: There are lots of different scales, so there’s not really a gold standard. Some of the use of those terms comes from the National Heart, Lung and Blood Institute guidelines that were last updated in 1997. Generally, mild asthma is considered a disease where people might need a bronchodilator–we heard the term albuterol before, that’s a good bronchodilator–maybe a couple of times a week. These people sleep well through the night, they have normal activity, they’re not missing time from school or work, and just need this sort of bronchodilator agent infrequently. When we get to several times a week–three, four, five times a week–we start to think that the problem is more moderate. This person really should have an ongoing medication that does more than just what a bronchodilator would do. When people are having ups and downs in their sleep and in their work and in school behavior and attendance that cause them to end up in emergency rooms or the hospital, then we think about it being a more severe disease. Having said that, people are certainly brought to a different level by control with the right medication. Somebody might be severe when no one is taking care of their illness, and then they might end up seeming rather mild when they get the right management plan together.

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