A Charter to Improve Patient Care in Severe Asthma

Abstract

Severe asthma is a subtype of asthma that is difficult to treat and control. By conservative estimates, severe asthma affects approximately 5–10% of patients with asthma worldwide. Severe asthma impairs patients’ health-related quality of life, and patients are at risk of life-threatening asthma attacks. Severe asthma also accounts for the majority of health care expenditures associated with asthma. Guidelines recommend that patients with severe asthma be referred to a specialist respiratory team for correct diagnosis and expert management. This is particularly important to ensure that they have access to newly available biologic treatments. However, many patients with severe asthma can suffer multiple asthma attacks and wait several years before they are referred for specialist care. As global patient advocates, we believe it is essential to raise awareness and understanding for patients, caregivers, health care professionals, and the public about the substantial impact of severe asthma and to create opportunities for improving patient care. Patients should be empowered to live a life free of symptoms and the adverse effects of traditional medications (e.g., oral corticosteroids), reducing hospital visits and emergency care, the loss of school and work days, and the constraints placed on their daily lives. Here we provide a Patient Charter for severe asthma, consisting of six core principles, to mobilize national governments, health care providers, payer policymakers, lung health industry partners, and patients/caregivers to address the unmet need and burden in severe asthma and ultimately work together to deliver meaningful improvements in care.Funding: AstraZeneca.

How can we minimise the use of regular oral corticosteroids in asthma?

“…For each statement, participants were further asked whether available evidence was of sufficient quality and were also asked to score their level of conviction/support. Evidence was graded according to the Oxford levels of evidence document [23].…”

“…These effects strongly impact quality of life. Fear of side-effects may induce a vicious circle related to poor adherence and poor control as well as medical nomadism [23]. In children, adverse behavioural effects of OCS bursts prescribed in asthma exacerbations have also been shown [145].…”

Independent risk factors for death in patients admitted for asthma exacerbation in Taiwan

“…31 The authors suggested that the interventions should be done at the patient level, at the health Menzies-Gow et al offered six core principles: timely diagnosis, referral, support of patients by providing relevant information about asthma and personalized education, treatment not reliant on OCSs, and access to consistent quality care, to address the unmet need in treating severe asthma and to deliver improvements in asthma care. 32 These strategies, based on the latest understanding of the disease, should be used to benchmark current service provisions. The results of this study will help health-care professionals to identify those who are at a higher risk of dying and those who need more specialized attention.…”

Rational oral corticosteroid use in adult severe asthma: A narrative review

“…Core management goals include timely and equitable access to severe asthma services, individualized management specific to the asthma phenotype and reduced AE associated with OCS. These goals are achievable if there is universal adoption of the principles by patients, healthcare professionals and policymakers, supported by appropriate resource allocation …”

“…In rheumatology, the advent of novel treatments, together with improved care through multidisciplinary teams, has revolutionalized treatment and substantially reduced OCS use . Recognition of the equivalent problem in respiratory medicine coupled to appropriate remedial strategies can therefore help to optimize OCS use …”