Taming Triggers to Control Asthma

Medications are a vital part of asthma management—but they’re not the only tool in your kit. Helping patients gain control of their asthma also means teaching them how to recognize and avoid the triggers that lead to flares.

Triggers are often overlooked in follow-up visits, yet managing them can make a significant difference in outcomes. Here’s a simple approach you can use at your next visit to help patients gain more control over their symptoms. To help patients breathe more freely, just remember to check for more AIR:

Ask about triggers, Investigate exposures, and Recommend a plan.

Common Asthma Triggers to Keep on Your Radar

Asthma is an obstructive pulmonary disorder characterized by reversible symptoms including wheezing and shortness of breath. Some of the most common asthma triggers include: 

• Respiratory infections
• Allergens, including environmental and food
• Irritants including tobacco smoke and volatile organic chemicals found in cleaners, deodorizers, perfumes and paints. 
• Temperature 
• Weather specifically thunderstorms
• Physical activity
• Hormonal fluctuations
• Medications including beta blockers, NSAIDs, and ACE inhibitors
• Stress & anxiety

To help our asthma patients get more AIR, remember to check for triggers!

 A - Ask about triggers. 

It starts with the conversation.

Patients with uncontrolled asthma often say that a cold or respiratory infection triggers a flare. Others report issues with weather changes, exercise, or household irritants.

Instead of waiting for patients to bring up triggers, take a proactive approach:

Pull up a list of common culprits and ask about each one.

To get a full picture, explore all aspects of the patient’s environment:

• Home
• Work
• School
• Daycare (for pediatric patients)

 I - Investigate further

It’s important to investigate identified triggers further to determine the degree to which the trigger impacts asthma symptoms. Ask questions about the frequency and duration of exposure to known triggers. Additionally, the severity of asthma symptoms and clinical significance of the symptoms should be investigated. Patients can be instructed to keep a diary to record exposures and peak expiratory flow readings to help determine the correlation between suspected triggers, symptoms, and lung function. 

R - Recommend a plan

After triggers are identified and investigated, it’s time to make a plan! Triggers that can be avoided should be, however, it’s not always possible to avoid every trigger. Steps to mitigate exposure to triggers should be explored. Here are some practical recommendations you can tailor to each patient:

• If dust is a trigger: Instruct patients to use damp cloths or mops instead of sweeping or dry dusting.
• If respiratory viruses are a concern: Emphasize hand hygiene, mask use in crowded spaces, and staying home when sick.
• If smoke is a trigger: Recommend complete smoke avoidance. For caregivers or family members who smoke, encourage them to smoke outside—ideally in designated areas far from living spaces.
• If household cleaners are a problem: Suggest switching to unscented, non-aerosol, and bleach-free products.
• If cold air is a trigger: Recommend using a scarf or mask over the nose and mouth during outdoor activities.
• If a known trigger is unavoidable: Instruct patients to use a short-acting beta-agonist (SABA) before exposure.

One Last Tool Worth Bookmarking

The Environmental Protection Agency, U.S. Department of Housing and Urban Development,  and Centers for Disease Control have put together a helpful tool that clinicians can use to help patients identify triggers and plan for action steps to reduce exposure. Pull up this tool to help discuss potential household triggers during your next asthma follow-up appointment. 

Medications are essential—but helping patients gain control over their environment can be just as impactful. Asking the right questions, identifying key triggers, and creating a clear, tailored plan empowers patients to prevent flares and feel more in control of their condition.