title: Practical guidance on the recognition of uncontrolled asthma and its management.
abstract: OBJECTIVE
  To highlight the significance of asthma in primary care and offer a practitioner-friendly interpretation of the asthma guidelines for the busy provider, while introducing new treatment options currently in clinical trials, such as the once-daily long-acting anticholinergic bronchodilator tiotropium Respimat.
  
  
  METHODS
  Articles with relevant adult data published between 2004 and 2015 were identified via PubMed. Additional references were obtained by reviewing bibliographies from selected articles.
  
  
  CONCLUSIONS
  In the United States, uncontrolled or symptomatic asthma is common, with rates of 46%-78% in primary care. Uncontrolled asthma has a substantial impact on patients' quality of life and represents a significant healthcare burden. Nurse practitioners can improve patients' asthma control through education, monitoring, assessment, and treatment. Although asthma management guidelines are readily available, the authors recognize that nurse practitioners see patients with multiple comorbidities, all of which have treatment guidelines of their own.
  
  
  CONCLUSIONS
  Nurse practitioners have a compelling opportunity as frontline caregivers and patient educators to recognize and assess uncontrolled asthma, along with determining the steps necessary to help patients gain and maintain symptom control.
authors.affiliation: College of Nursing, University of Alabama in Huntsville, Huntsville, Alabama.
authors.forename: Haley M
authors.initials: HM
authors.lastname: Hoy
authors.affiliation: College of Nursing, University of Alabama in Huntsville, Huntsville, Alabama.
authors.forename: Louise C
authors.initials: LC
authors.lastname: O'Keefe
mesh_terms: D001249:Asthma / Q000451:nursing / Q000517:prevention & control*; D006801:Humans; D009722:Nurse Practitioners; D017410:Practice Guidelines as Topic; D057184:Practice Patterns, Nurses'
keywords: Uncontrolled asthma; exacerbation; practical guidance; symptomatic asthma; tiotropium