In asthma management, what should be the primary focus for a patient with frequent exacerbations?

The primary focus for a patient experiencing frequent exacerbations of asthma should be to enhance control with a daily medium-dose inhaled corticosteroid (ICS). This approach is fundamental because inhaled corticosteroids are the most effective anti-inflammatory medications for asthma management. They work by reducing airway inflammation, which is a key component of asthma exacerbations. By using a daily medium-dose ICS, patients can achieve better control over their asthma symptoms and reduce the frequency of exacerbations.

Increasing the usage of short-acting beta-agonists is not an appropriate strategy for managing frequent exacerbations, as these medications are intended for quick relief rather than long-term control. Relying heavily on them may lead to overuse and does not address the underlying inflammation that characterizes asthma.

Monitoring peak flows more frequently is important for some patients, but in this context, enhancing control with ICS is the priority. Insufficient peak flow monitoring can lead to missed signs of worsening asthma control, but without addressing the underlying inflammation, those efforts may not be sufficient.

Switching to oral medications only may be necessary in some very specific cases, but generally, inhaled corticosteroids are preferred over oral therapies due to their effectiveness and lower side effect profile. Oral medications typically serve as an adjunct rather than a