Structured evaluation of difficult asthma improves asthma control

Published online: March 8, 2017

Patients with asthma have disease that is difficult-to-control despite access to excellent medical care. Their quality of life is poor, their risk of asthma flares is high, and some even die from their asthma. Although many of these patients have severely impaired airway function, many of these patients also have other medical conditions, termed co-morbidities, and impacting asthma control. Because these patients have such complex asthma, their care can be very challenging.  

In a recent study published in The Journal of Allergy and Clinical Immunology: In Practice, Dr Tay and her colleagues, assessed and treated patients with difficult-to-control asthma using a standardized protocol. The protocol focused on confirming the diagnosis of asthma, assessing for and treating comorbidities known to worsen asthma control, as well as addressing other contributory factors. Each patient’s evaluation included a battery of questionnaires, a computer-assisted consultation, a case discussion among a panel of asthma experts, and specialist nurse education. Other health care professionals were also brought in to assist as needed.

At the third clinic visit after six months, patient progress was reassessed. For most patients, there were major improvements in asthma control and the frequency of asthma flares. Important comorbidities were also better controlled. In many patients, this was accomplished without having to increase their asthma medications.

Based on this study, systematically assessing and treating patients with difficult-to-control asthma does improve asthma outcomes. The proposed protocol can be implemented in other asthma centres to help manage this challenging group of patients.

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

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