The GP may suspect the diagnosis of asthma on the basis of a thorough history-taking (level of evidence 3)

The diagnosis of asthma can be confirmed by noting reversible obstructive lung disease on the basis of correctly performed spirometry. Use of the peak flow meter for diagnosing and monitoring asthma is not recommended (level of evidence 2).

Only in the case of resistance to therapy or distinctly allergen-related symptoms, can allergological investigation using the RAST test (or skin test) be performed (level of evidence 3).

On the basis of the pattern of symptoms and the FEV1 (by spirometry), asthma is divided into intermittent, mild persistent, moderate persistent and severe persistent asthma. This classification also determines the stipulated treatment regimen (level of evidence 3).

In managing asthma, it is important to avoid triggering factors:

• typical allergens: household pets and pollen (level of evidence 3);

• there is disagreement on clearing the indoor environment of house-dust mites (level of evidence 2):

• annual vaccination against influenza (level of evidence 3);

• no smoking and avoidance of combustion gases (level of evidence 3).

In a symptomatic asthma patient, the combination of a long-acting betamimetic with an inhalation steroid is more effective than increasing metered-dose inhalation steroids (level of evidence 1).

An asthma patient can monitor his or her symptoms and adjust maintenance treatment. This self-management has a proven effect (level of evidence 2). We recommend doing this on the basis of a diary (level of evidence 3).

Treatment of the attack in the case of an acute episode of asthma consists in inhaling a beta-2-mimetric (salbutamol), where appropriate in combination with an anticholinergic (ipatropium bromide) (level of evidence 2).