TY - JOUR
T1 - Achieving asthma control in practice
T2 - Understanding the reasons for poor control
AU - Haughney, John
AU - Price, David
AU - Kaplan, Alan
AU - Chrystyn, Henry
AU - Horne, Rob
AU - May, Nick
AU - Moffat, Mandy
AU - Versnel, Jennifer
AU - Shanahan, Eamonn R.
AU - Hillyer, Elizabeth V.
AU - Tunsäter, Alf
AU - Bjermer, Leif
PY - 2008/12
Y1 - 2008/12
N2 - Achieving asthma control remains an elusive goal for the majority of patients worldwide. Ensuring a correct diagnosis of asthma is the first step in assessing poor symptom control; this requires returning to the basics of history taking and physical examination, in conjunction with lung function measurement when appropriate. A number of factors may contribute to sub-optimal asthma control. Concomitant rhinitis, a common co-pathology and contributor to poor control, can often be identified by asking a simple question. Smoking too has been identified as a cause of poor asthma control. Practical barriers such as poor inhaler technique must be addressed. An appreciation of patients' views and concerns about maintenance asthma therapy can help guide discussion to address perceptual barriers to taking maintenance therapy (doubts about personal necessity and concerns about potential adverse effects). Further study into, and a greater consideration of, factors and patient characteristics that could predict individual responses to asthma therapies are needed. Finally, more clinical trials that enrol patient populations reflecting the real world diversity of patients seen in clinical practice, including wide age ranges, presence of comorbidities, current smoking, and differing ethnic origins, will contribute to better individual patient management.
AB - Achieving asthma control remains an elusive goal for the majority of patients worldwide. Ensuring a correct diagnosis of asthma is the first step in assessing poor symptom control; this requires returning to the basics of history taking and physical examination, in conjunction with lung function measurement when appropriate. A number of factors may contribute to sub-optimal asthma control. Concomitant rhinitis, a common co-pathology and contributor to poor control, can often be identified by asking a simple question. Smoking too has been identified as a cause of poor asthma control. Practical barriers such as poor inhaler technique must be addressed. An appreciation of patients' views and concerns about maintenance asthma therapy can help guide discussion to address perceptual barriers to taking maintenance therapy (doubts about personal necessity and concerns about potential adverse effects). Further study into, and a greater consideration of, factors and patient characteristics that could predict individual responses to asthma therapies are needed. Finally, more clinical trials that enrol patient populations reflecting the real world diversity of patients seen in clinical practice, including wide age ranges, presence of comorbidities, current smoking, and differing ethnic origins, will contribute to better individual patient management.
KW - Asthma
KW - Nonadherence
KW - Poor control
KW - Primary care
KW - Smoking
KW - Tools
UR - http://www.scopus.com/inward/record.url?scp=55849150176&partnerID=8YFLogxK
U2 - 10.1016/j.rmed.2008.08.003
DO - 10.1016/j.rmed.2008.08.003
M3 - Review article
C2 - 18815019
AN - SCOPUS:55849150176
SN - 0954-6111
VL - 102
SP - 1681
EP - 1693
JO - Respiratory Medicine
JF - Respiratory Medicine
IS - 12
ER -