Coordinating allergy and asthma care

Asthma commonly presents with variable wheezing, cough, chest tightness and shortness of breath. Allergic rhinitis affects the nose but may occur alongside asthma, and exposure to a relevant allergen can aggravate symptoms in both airways. House dust mites, pollen, mould or animals are useful suspects only when the symptom pattern and assessment support the connection.

Treatment has separate jobs: preventer medicine reduces airway inflammation, reliever medicine addresses acute narrowing, and nasal therapy targets rhinitis. Feeling better does not necessarily mean preventer treatment should be stopped; medicine changes should follow the agreed plan.

Track daytime symptoms, sleep disturbance, activity limits, nasal symptoms, triggers and reliever use. Bring every inhaler, spacer and nasal device to reviews so technique can be observed. A written asthma action plan should explain routine medicines, how to recognise worsening control, what treatment changes are authorised, and when to obtain urgent help.

Reduce confirmed exposures in practical ways, such as dealing with damp, keeping smoke and vaping away from the home, or using bedding measures when mite allergy is established. Avoid expensive or burdensome environmental changes based on guesswork. Regular review can also identify missed doses, an empty device, poor technique or another cause of chronic cough.

Call emergency services if breathlessness is severe, speech is limited to short phrases, lips appear blue or grey, the person becomes drowsy or confused, or prescribed reliever medicine is not helping. Follow the emergency section of the asthma action plan while help is coming.

Book prompt review when symptoms wake you, usual activities become harder, wheezing or chest tightness is increasing, or reliever use exceeds the personal plan. These are signs of poorer control and may require reassessment of treatment, technique, adherence, triggers or diagnosis.

Ask the clinician to demonstrate correct inhaler and spacer use, define the role of each medicine, and update the written action plan. Discuss whether allergy testing would alter avoidance or treatment, how nasal symptoms should be managed, and which changes in cough, wheeze or chest tightness require same-day care.