Adjunctive therapy

These measures should be optimized in all patients to reduce antiasthmatic medication requirements and decrease the frequency of acute asthma exacerbations. [3][11][12]

• Reducing exposure to triggers or allergens

  • Indoor/outdoor allergens (e.g., dust, pollen, dust mites)

  • Occupational exposure

  • Medications

  • Consider allergen immunotherapy in allergic asthma.

• Obesity

• Rhinosinusitis and nasal polyps

• Anxiety and depression

• PPI if GERD is suspected

• Reducing the risk of infection-induced exacerbations

  • Early treatment of infections in infection-triggered asthma

  • Immunizations (influenza, pneumococcal vaccines)

• Lifestyle recommendations

  • Provide information and tools for self-monitoring and self-management (e.g., written action plan, peak flow meter).

  • Encourage physical activity, especially in younger patients.

  • Smoking cessation

• Social interventions

Controlling modifiable risk factors (e.g., smoking cessation) and comorbidities (e.g., GERD, sinusitis) can lead to better symptom control, often allowing for a step down in treatment.