Asthma - the importance of keeping a daily asthma diary

Written by The National Asthma Campaign, and Dr Martyn R Partridge, consultant physician

Why should I keep an asthma diary?

Managing your asthma is not just about taking the correct medication and following dosage instructions. This is of course the most important part of keeping your asthma well controlled but it is by no means the only thing you can do.

You can help yourself take control by avoiding triggers that tend to bring on your asthma symptoms.

Asthma is a variable condition and no two people's asthma is likely to be identical. That is why it is important to learn all you can about your asthma and your personal triggers. Sometimes it can be difficult to identify exactly what triggers your asthma. A trigger may be obvious, such as symptoms starting shortly after coming into contact with a cat or a dog. At other times some detective work is needed and this is where keeping a daily asthma diary can help.

What is involved in keeping a daily asthma diary?

An asthma diary can be as simple or as detailed as you wish. However, the more detail you include, the more use it will be not only on a personal level, so you really learn about your own asthma, but also for your doctor or practice nurse.

The more information you provide to your health professional, the better they are able to more accurately tailor the treatment to your needs.

The ideal diary

It is important to keep a record of your:

peak flow readings

symptoms

medication

daily activities.

Your peak flow readings

A peak flow is a measurement of how hard you blow air in and out of your lungs. You get this reading by blowing into a small plastic tube called a peak flow meter.

Most adults and children over six years of age can use a peak flow meter. The meter has a marker, which slides up the scale as you blow out.

The better controlled your asthma, the harder you'll be able to blow out and the higher your peak flow scores will be.There are different types of sizes of peak flow meters for adults and children if required.

Measuring your peak flow is important because:

you can tell what is going on in your airways rather than just guessing by the way you feel.

you can find out if the treatment is having the effect it should.

you will know whether you need to change your treatment.

your doctor or practice nurse will be able to see how well you have been.

Your symptoms

It is a good idea to keep a record of your symptoms and whether they get better or worse. Note the times when your symptoms are worse and anything you think may have triggered them. This will help you establish exactly what your triggers are and take measures to avoid the things that bring on your symptoms.

If you notice any of the following, then you should see your doctor who can help you to bring your asthma back under control:

waking at night with coughing, wheezing, shortness of breath or tight chest.

increased shortness of breath on waking up in the morning.

needing more and more reliever treatment, or if the reliever treatment does not seem to be working well.

having difficulty keeping up with your usual level of activity or exercise.

Your medication

It is important to record both the medication you take and the times that you take it. This includes both your asthma medication and anything that you buy over the counter. This will allow you and your doctor or practice nurse to see:

how well controlled your asthma is.

how effectively the medication is controlling your asthma.

whether or not you need to increase or decrease your medication.

whether or not you are sensitive to certain over-the-counter medicines.

Your daily activities (specific activities to include)

You may find it useful to record daily activities and the effect they have, if any, on your asthma. Again this will give a clearer picture of how well your asthma is controlled. For example, you may feel that your asthma is well controlled but notice you have difficulty when running for a bus. Or your asthma may worsen when you exercise.

Your doctor or practice nurse will then be able to give you the advice you need to be able to continue with these activities.

Keeping a note of all of the above will help give a very clear indication of how good or bad your asthma is and what activities or triggers affect you. Your doctor or practice nurse will then be able to develop a written self-management plan tailored to your individual needs.

A self-management plan details the best treatment for you and tells you when to adjust it, which may be an increase or reduction of medication - the plan can help you manage your own condition. Scientific studies have shown that people with asthma who follow a written self-management plan have better control of their asthma and experience fewer asthma attacks.

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