Has the Treatment of Asthma Improved?

Higenbottam, Tim; Hay, I.F.C.

doi:10.1378/chest.98.3.706

Cited by 19 publications

(8 citation statements)

References 32 publications

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“…The incidence, prevalence and severity of asthma are still increasing [1], and an increase in the number of patients with chronic bronchitis or emphysema (COPD) is expected in coming years, because of the increasing percentage of elderly in the population [2]. Numerous effective pharmacological treatments have become available in the past three decades, but many patients still suffer wmecessarily from their asthma or COPD [3]. It has been suggested that physicians fail to apply these treatments [3].…”

mentioning

confidence: 99%

Compliance with pulmonary medication in general practice

Dekker¹,

Dieleman²,

Aa³

et al. 1993

Eur Respir J

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We wanted to assess compliance with regular pulmonary medication, in 156 patients in a general practice setting. Patients completed a questionnaire on their reported daily intake, the perceived prescription, and their self-assessed perceived compliance with pulmonary medication. Compliance was defined as a reported daily intake > or = 50% of the prescribed amount. Using this definition, 30% of patients were considered to be compliant. Compliant patients had daily symptoms more often, were more often prescribed two or more different medications, and a greater proportion of them had at some time consulted a chest physician. When patients correctly perceived the prescription to refer to medication which had to be taken on a regular basis, they were more likely to be compliant. We conclude that, since less than one third of patients was compliant with medication, more efforts are needed to improve compliance in general practice. Non-compliance with medication may well provide an alternative explanation for the discrepancy between prescribed medication and medical outcome, which has been labelled in the literature as "undertreatment".

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confidence: 99%

Compliance with pulmonary medication in general practice

Dekker¹,

Dieleman²,

Aa³

et al. 1993

Eur Respir J

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“…A necessidade de educação do paciente asmá-tico vem sendo bastante enfatizada pela literatura, principalmente em artigos de revisões de óbitos (Collins-Williams et al, 1981), nos protocolos de atenção à asma já citados, nos de avaliação da assistência hospitalar (Fitzgerald & Hargreave, 1989;Bucknall et al, 1988), e em artigos de revisão do tratamento realizados por especialistas (Higenbottam & Hay, 1990;Campos, 1994;Serafini, 1992). Por ser a asma uma doença crônica, o seu adequado controle pressupõe uma boa compreensão da doença e de seu manejo pelo paciente e/ou familiares, pois muitos dos desfechos trágicos têm ocorrido devido à desinformação.…”

Section: Educação Do Pacienteunclassified

“…A partir de revisão bibliográfica, verificouse que a hipótese explicativa mais importante refere-se à possibilidade de fatores relacionados ao tratamento terem levado a uma maior freqüência de óbitos, seja pelo manejo inadequado da doença, seja em conseqüência da adoção de práticas terapêuticas inadequadas (Burr, 1987;Serafini, 1992;Benatar, 1986;McFadden & Gilbert, 1992;Sears, 1988;Higenbottam & Hay, 1990). Portanto, mesmo considerando que o aumento da mortalidade por asma em vários países seja multifatorial, torna-se essencial rediscutir o papel da atenção médica e os possí-veis "fatores evitáveis" relacionados com os óbi-tos pela doença.…”

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Proposta de indicadores e padrões para a avaliação de qualidade da atenção hospitalar: o caso da asma brônquica

Noronha

Machado²,

Lima³

1996

Cad. Saúde Pública

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“…The number of episodes of acute, near-fatal asthma [7], as well as the number of asthma admissions [1], have increased more in recent years than asthma mortality rates [8]. Although a British survey [9] of Emergency Room deaths from medical conditions has pointed out the importance of proper recognition and assessment of life-threatening asthma, the prevalence of this type of episode is largely unknown [1].…”

Section: Definition and Incidencementioning

confidence: 99%

“…Many patients with severe asthma respond satisfactorily to these measures in a few hours; however, no patient recovering from a life-threatening event should be discharged [6] before a monitoring period in hospital of at least 24 h. Home monitoring may be sufficient for most patients discharged from the emergency room [8,87] but patients with life-threatening events can have sudden overwhelming fluctuations in pulmonary function and need close supervision in hospital [17]. Criteria for hospital admission of patients with acute severe asthma treated at the Emergency Department have recently been summarized [13][14][15].…”

Section: Treatmentmentioning

confidence: 99%

Near-fatal asthma

Molfino¹,

Slutsky²

1994

Eur Respir J

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The prevalence of patients with acute severe asthma appears to be increasing in many countries. In the present review, we summarize data in the literature relating to the prevention and treatment of fatality-prone asthmatics. The underlying assumption is that increased understanding of near-fatal asthma will increase our understanding of the pathophysiology of severe asthma, and lead to interventions that could reduce the mortality rate from asthma. Recognition of acute life-threatening asthma attacks by any physician is mandatory, since lack of such diagnosis and appropriate treatment has been shown to have devastating consequences. The characteristics that allow identification of asthmatics prone to die in ambulatory settings (i.e. previous admissions, type of therapy, etc.) as well as the principal precipitating factors of acute near-fatal and fatal attacks of asthma are reviewed. Predisposing factors, such as lack of appropriate treatment, lack of compliance or poor preventive measures are debated. Finally, we discuss current therapeutic approaches in emergency facilities, based on the major pathophysiological findings in near-fatal asthma.

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Has the Treatment of Asthma Improved?

Cited by 19 publications

References 32 publications

Compliance with pulmonary medication in general practice

Compliance with pulmonary medication in general practice

Proposta de indicadores e padrões para a avaliação de qualidade da atenção hospitalar: o caso da asma brônquica

Near-fatal asthma

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