This shared component provides a structured way to record decisions around stepping up or stepping down asthma maintenance therapy, based on the patient's symptom control and clinical course.
During an asthma review
Field | Purpose |
| Step-Up Implemented | Tick if stepping up therapy due to poor control, with supporting notes |
| Step-Down Considered | Tick if stepping down therapy due to sustained good control |
| Details of Change | Optional free-text to record specific treatment adjustments and rationale |
📘 Make sure to also update the Self-Management Plan and arrange follow-up if medication is changed
Only consider if asthma well-controlled for at least 3 months
Gradual reduction in inhaled corticosteroid (ICS) dose or simplification of regimen
Monitor carefully and review action plan thresholds
Consider if patient has had:
≥2 exacerbations in past 12 months
Poor ACT score or frequent reliever use
Poor adherence or incorrect inhaler technique already addressed
Increase ICS dose or add-on therapy (LABA, LTRA)
“Have you been using your reliever inhaler more often recently?”
“Do you feel your symptoms have been well controlled?”
“Would you be open to adjusting your preventer medication to match how things are going?”