Advances in Evaluation and Treatment of Severe Asthma (Part One).

Med Clin North Am

Partners Asthma Center, Pulmonary and Critical Care Medicine Division, Brigham and Women's Hospital, Harvard Medical School, PBB - Clinics 3, 75 Francis Street, Boston, MA 02115, USA. Electronic address:

Published: November 2022

AI Article Synopsis

  • Around 15%-20% of asthma patients struggle with poorly controlled symptoms despite using inhaled corticosteroids and long-acting bronchodilators, leading to significant health risks.
  • The article suggests a systematic evaluation to pinpoint and address factors that worsen asthma, focusing on accurate diagnosis and reducing exposure to triggers.
  • It emphasizes managing related health issues and ensuring proper medication use, recommending a basic lab assessment tailored to each patient's needs.

Article Abstract

As many as 15% to 20% of patients with asthma have incompletely or poorly controlled asthma despite treatment with inhaled corticosteroids and long-acting beta-agonist bronchodilators. They are vulnerable to burdensome symptoms, limitations to their exercise capacity, and asthma attacks that can be frightening and potentially life-threatening. This article outlines a systematic approach to their evaluation, attempting to identify remediable factors that are making their asthma more severe than most other persons with asthma. This approach includes an emphasis on ensuring the correct diagnosis, minimizing exposures to stimuli that worsen airway inflammation, alleviating modifiable comorbidities such as chronic rhinosinusitis and gastroesophageal reflux, and supporting regular medication adherence and effective technique for administering inhaled medications. A basic diagnostic laboratory work-up is recommended, to be modified and amplified according to individual patient needs.

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Source
http://dx.doi.org/10.1016/j.mcna.2022.08.003DOI Listing

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