African American children experience a disproportionate burden in asthma. Symptom-based, intermittent inhaled corticosteroid (ICS) adjustment, or SBA (symptom-based adjustment: use of ICS together with rescue short-acting bronchodilator or inhaler), is a patient-centered approach in which patients adjust their ICS dose on a daily basis guided by symptoms and albuterol need. In controlled trials in highly selected, adherent adults and children with mild asthma, SBA was as effective as provider-driven, guideline-based management, or PBA (provider-based adjustment: daily ICS with subsequent ICS dose adjustment by provider).
