Annual Asthma Prescription Check: Why It Matters for Your Breathing Health

July 16, 2025/Andrew Le

Asthma isn’t a fixed condition. Over time, your triggers may change, symptoms can become more frequent or severe, and your response to medication might shift. In 2023 alone, 3,190 people died from asthma. Deaths that were largely preventable with consistent and effective care.

Your chance of surviving asthma mostly depends on how well your lungs work. People with the poorest lung function are eight times more likely to die from asthma than those with better lung function.

One major factor behind poor outcomes is the lack of regular asthma management, including missed yearly prescription reviews. In this article, we’ll explain what an annual asthma prescription check involves, why it matters for your long-term respiratory health, and how it can help you stay in control of your breathing.

🔑 Key Takeaways

➤ Asthma prescription reviews help determine whether your current treatment plan is still effective or needs updating. They go beyond renewing prescriptions by assessing symptom patterns, lung function, and any medication-related issues.

➤ Asthma control can quietly decline without obvious warning signs. A yearly check ensures subtle changes don’t go unchecked, reducing your risk of serious flare-ups or hospital visits.

➤ Poor inhaler technique remains one of the biggest barriers to effective asthma treatment. Up to 70% of people use their inhalers incorrectly, which directly impacts symptom control.

➤ Tools like spirometry and ACT scores offer an objective way to measure asthma control.

➤ You may need higher doses or additional drugs if your asthma isn’t well controlled. On the other hand, if you’ve been stable, your provider might reduce or “step down” your medication safely to minimize side effects.

➤ Medical advice changes as new research emerges. Regular reviews ensure you benefit from the latest, most effective options.

What Is an Asthma Prescription Review?

An asthma prescription review is a yearly appointment, usually with your primary care physician or pulmonologist, where your current treatment is evaluated in full. This may involve:

  • Reviewing your medication list (including inhalers and oral meds)
  • Discussing any recent asthma symptoms or attacks
  • Performing spirometry or peak flow tests to assess lung function
  • Identify and address any side effects
  • Adjusting doses or changing medications if necessary
  • Ensuring you’re using inhalers correctly

Whether you’re newly diagnosed or have had asthma for decades, your treatment plan may change.

How to Schedule Your Asthma Prescription Review

Most people can have this review with their primary care physician, but if your asthma is severe or difficult to control, a referral to a pulmonologist may be appropriate.

You can call your doctor’s office and request a “medication management appointment” or “asthma check-up.” Let them know you’re due for an asthma prescription renewal. Some clinics may also offer virtual appointments for this type of review, especially if you live in a remote area.

What to Bring to Your Annual Asthma Review

Before heading to your asthma check-up, it’s smart to gather everything you’ll need to help your doctor fully understand how well your current treatment is working.

Here’s a list of what you should bring:

  1. Your current inhalers and medications – Bring all your inhalers, spacers, or any asthma-related medications, even if you’re not using them regularly. Your doctor needs to check expiration dates, doses, and your technique.
  1. A list of symptoms or flare-ups – If you’ve had coughing fits, chest tightness, shortness of breath, or nighttime awakenings, write them down. Try to note how often they happen and if anything triggers them.
  1. Peak flow or symptom diary (if you keep one) – If you track your breathing or symptoms, bring those notes with you. It helps your doctor spot patterns or worsening control.
  1. Questions or concerns—Think about anything that’s been bothering you. Maybe your inhaler feels less effective, or you’ve had trouble sticking to your medication schedule. Write those down so you don’t forget during the visit.
  1. Insurance or pharmacy details – If your insurance changed or you had trouble refilling your meds, let your provider know. They may be able to switch you to a more affordable option.

Being proactive during the visit can lead to better outcomes.

🙌 Helpful Tip

Don’t hesitate to speak up during your appointment. Some good questions to ask include:

➤ “Is my asthma considered well-controlled right now?”
➤ “Should I change the dosage or type of medication?”
➤ “Are there newer medications or inhaler devices I should know about?”
➤ “How can I prevent future asthma attacks?”
➤ “Can you check my inhaler technique?”
➤ “What should I do if my symptoms get worse?”

These questions open the door to a more thorough discussion of your treatment plan.

How Doctors Assess Your Asthma Control

Your healthcare provider will likely consider several tools to evaluate how well your asthma is managed. These include:

  1. Asthma Control Test (ACT)

A short questionnaire that helps doctors understand how well your asthma is controlled. You’ll answer 5 questions about your symptoms over the past 4 weeks, like:

  • How often you’ve had trouble breathing
  • Whether asthma interferes with daily activities
  • How often you’ve used your rescue inhaler

Each answer is scored 1 to 5. The total score ranges from 5 to 25:

ScoreMeaning
20-25Well controlled
16-19Not well controlled
15 or belowPoorly controlled
  1. Spirometry

This measures how much air you can blow out (your lung volume) and how fast you can do it. You’ll be asked to take a deep breath and blow out forcefully into a tube connected to a spirometer. It records two main things:

  • FEV1 (Forced Expiratory Volume in 1 second): how much air you blow out in the first second.
  • FVC (Forced Vital Capacity): the total air you can blow out after a deep breath.

Sometimes, your spirometry may look normal, especially if you’re not having symptoms that day, have been taking controller meds, or used your inhaler too recently.

  1. Bronchodilator Response (BDR) Test

This test measures how much your lung function improves after using a quick-relief inhaler. After your first spirometry test, you’ll be given 2 to 4 puffs of a bronchodilator like albuterol. You’ll then wait 10 to 15 minutes and repeat the spirometry.

If your FEV1 increases by at least 12% or 200 mL, it’s a positive BDR, meaning your lungs respond well to asthma medication.

  1. Peak Flow Meter

Peak flow meter readings examine how fast you can blow air out of your lungs. You take a deep breath and blow as hard as possible into a small handheld device. You’ll do this 3 times and record the highest number.

  1. Exhaled Nitric Oxide Test (FeNO)

This measures the level of inflammation in your airways. You’ll exhale slowly into a machine that measures the amount of nitric oxide in your breath. High levels mean there’s eosinophilic inflammation, a common feature in asthma.

FeNO is not a required part of every asthma prescription review, but it’s a helpful, optional tool your doctor may use, especially if:

  • If your symptoms and spirometry don’t match up. For example, you feel breathless, but your lung function looks normal.
  • To check if you’re responding well to steroids or if your medication plan needs tweaking.
  • When considering biologic treatments (like anti-IgE or anti-IL5 therapies), FeNO helps determine if you’re a candidate.

It’s especially useful for checking if you’ll respond to inhaled steroids.

  1. Chest Imaging (Only When Needed)

A chest X-ray or CT scan to see inside your lungs is usually used:

  • If you’re over 40 and newly diagnosed
  • If your symptoms are not improving with treatment
  • If something unusual is suspected, like a tumor compressing your windpipe, lung infection, COPD, or heart failure

Your doctor may also ask questions or look for signs that suggest you’re at higher risk of a severe asthma attack. These results help guide decisions about whether to adjust your medications.

When Your Prescription Might Need Changing

Not everyone will need a change in their medications, but if any of the following apply to you, an update may be recommended:

  • You’re using your rescue inhaler (like albuterol) more than two days a week (excluding use before exercise).
  • You’re waking up at night due to asthma symptoms, especially more than twice a month.
  • You’ve had more than one asthma attack in the past year, sometimes requiring ER visits or hospitalizations.
  • Your Spirometry test results show a drop in FEV1 or your FEV1/FVC ratio is lower than before, indicating worsening airway obstruction.
  • Your Asthma Control Test score is below 20.
  • Your daily controller isn’t easing symptoms anymore.
  • You’ve developed new health conditions or take new medications.
  • You’re experiencing side effects you didn’t have before such as hoarseness, sore throat, tremors, or rapid heartbeat.

If any of these situations sound familiar, bring them up during your checkup.

Common Medication Adjustments Made During Reviews

Here are the most common medication changes made during these reviews:

  1. Increasing the Dose of Controller Medications

If your asthma is not well-controlled, your doctor might raise the dose of your inhaled corticosteroid (ICS) or combination inhaler (like ICS + LABA). This helps reduce airway inflammation and prevent flare-ups.

  1. Stepping Down Treatment

If your asthma has been well-controlled for several months, your doctor might recommend lowering your dose or removing a medication. This is done gradually to avoid triggering symptoms and is part of asthma “step-down” therapy.

  1. Switching Inhaler Devices

You may be switched to a different inhaler device if:

  • You’re struggling with proper technique
  • You have arthritis or coordination problems
  • The current inhaler isn’t delivering the medication effectively

Dry powder inhalers (DPI), metered-dose inhalers (MDI), and soft mist inhalers are tailored based on age, ability, and preference.

  1. Adding a Long-Acting Bronchodilator (LABA or LAMA)

If symptoms persist despite using a daily steroid inhaler, your doctor might add:

  • A LABA (long-acting beta-agonist), such as formoterol or salmeterol
  • A LAMA (long-acting muscarinic antagonist), like tiotropium, especially for adults with persistent symptoms
  1. Considering Biologic Therapies

For severe or allergic asthma, your provider may suggest starting a biologic medication (e.g., Xolair, Dupixent, or Fasenra). These are usually given by injection and target specific immune pathways involved in asthma.

  1. Adding Leukotriene Receptor Antagonists (LTRAs)

You might be prescribed an LTRA (like montelukast) if you have exercise-induced symptoms, allergic rhinitis, or if you prefer an oral option alongside inhalers.

  1. Discontinuing or Replacing Medications with Side Effects

If you’re experiencing bothersome side effects (e.g., hoarseness from inhaled steroids or jitteriness from bronchodilators), your doctor might:

  • Lower the dose
  • Switch to a different drug class
  • Change the delivery method
  1. Adjusting Rescue Inhaler Plans

If you’re using your rescue inhaler too often, your doctor may increase your controller dose or consider switching to a SMART regimen, where a formoterol-containing combination inhaler is used as both maintenance and rescue therapy.

These changes are made based on your symptoms, lung function, and lifestyle.

Why a Yearly Review Is Important

What worked for you last year might not be the best option now. Here are some of the reasons why you should not skip your annual asthma prescription check:

  1. Asthma control can worsen without you realizing

Some people get used to mild symptoms and think their asthma is “under control.” But if you need to catch your breath during routine tasks, or cold weather starts to trigger symptoms more than before, your asthma may not be as stable as you think.

An annual review helps identify these subtle changes early, so your provider can take steps to get you back on track.

A 2018 study looked at health insurance data from Korea and included over 700,000 people with asthma who were 15 years or older. They grouped people into regular visitors and infrequent visitors. Results showed that people who went to regular checkups had a much lower chance of needing:

  • 52% lower odds of being hospitalized in a general ward for asthma
  • 17% lower odds of needing emergency room care
  • 51% lower odds of being admitted to an intensive care unit (ICU)

Even after accounting for other factors like age, health status, and hospital type, regular doctor visits made a big difference.

  1. Inhaler technique is easy to get wrong

A common reason people don’t fully benefit from their asthma treatment is incorrect inhaler use. Research shows that up to 70% of individuals with asthma use their inhalers improperly. Even small mistakes, such as forgetting to shake the inhaler, not breathing in deeply, or skipping the use of a spacer, can reduce how well the medication works. People with poor inhaler technique are up to four times more likely to have uncontrolled asthma compared to those who use their inhalers correctly.

During your check-up, a provider can observe your inhaler use and give helpful feedback. This alone can significantly improve how well your medication works.

  1. Medication guidelines change

Asthma treatment recommendations are not set in stone. The Global Initiative for Asthma (GINA) frequently updates its guidance based on new research. For instance, many doctors now prescribe SMART, which stands for Single Maintenance and Reliever Therapy.

This newer approach to asthma management allows you to use one inhaler for both daily control and quick relief. Instead of having separate inhalers (one for maintenance and another for rescue), SMART uses a combination inhaler that contains both an inhaled corticosteroid (ICS) and formoterol, a fast-acting long-acting beta agonist (LABA).

This strategy is recommended by the GINA and the US National Asthma Education and Prevention Program (NAEPP). There were two main reasons behind this change in treatment strategy.

First, updated clinical research showed better results with ICS-formoterol used as needed, compared to traditional SABA use. The SYGMA-1 study and two additional real-world studies, PRACTICAL and Novel START, found that patients using ICS-formoterol had fewer serious asthma flare-ups than those relying solely on SABA.

Second, concerns about SABA safety have continued to grow. These worries date back to the 1980s, when New Zealand saw a spike in asthma deaths connected to frequent SABA use.

A recent large-scale Swedish study reinforced this concern. It found that individuals using 3-5 SABA canisters per year had a 26% increased risk of severe asthma attacks, and those using more than 11 canisters annually faced a 77% greater risk of attacks, and more than double the risk of death.

  1. Side effects may build over time

All medications have potential side effects. You might develop a hoarse voice, oral thrush, tremors, or an elevated heart rate from certain asthma medications, especially if you’re using them more frequently than prescribed.

Your doctor can recommend dosage adjustments or alternatives to help reduce unwanted effects while maintaining asthma control.

  1. Life circumstances change

Changes in weight, activity level, other health conditions (like pregnancy or high blood pressure), or even moving to a new environment can influence asthma severity. Your doctor can help tailor your prescription to reflect your current needs.

Wrap-up

Your asthma prescription isn’t something to set and forget. Just like your car needs routine maintenance, your asthma treatment plan needs regular fine-tuning. An annual asthma prescription check can catch small issues before they grow into major problems, keeping you safe, symptom-free, and in control of your life.

Frequently Asked Questions

Is an asthma prescription check covered by insurance?

Most insurance plans, including Medicare and Medicaid, typically cover annual asthma reviews under preventive or chronic disease management visits. You may need a referral depending on your plan.

Do children with asthma need an annual checkup too?

Absolutely. Children’s asthma changes quickly with growth and exposure to new environments. Pediatricians usually recommend at least one asthma management review per year.

Can I use telehealth for my asthma prescription check?

Yes, especially for stable cases. However, certain tests like spirometry must be done in person. You can discuss symptoms, medication concerns, and plan adjustments virtually.

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