Controlling asthma so as to allow a person to carry out routine daily activities is achievable provided the patient is involved in a comprehensive treatment approach, according to new guidelines on asthma control devised by the National Heart, Lung, and Blood Institute.
The guidelines stress on patient information and timely medical care. Asthma is a chronic disease that affects the lungs or the airways. In this disease the airways are inflamed or swollen making it difficult to breathe. the swollen airways are sensitive to allergens or irritating substances.
Each time an asthma patient is exposed to an allergy causing substance, his airways contract and become narrow leading to classical symptoms like coughing, wheezing (a whistling sound when you breathe),chest tightness, according to the National Institutes of Health.
According to the U.S. Centers for Disease Control and Prevention, asthma causes 500,000 hospitalizations each year and is responsible for over 4,000 deaths annually. It is estimated that over 22 million Americans suffer from asthma, including 6.5 million children under age 18.
The problem is asthma cannot be cured, but most people with asthma can control it so that they have few and infrequent symptoms and can live active lives.
And it is this principle that the new guidelines seek to propagate. The Expert Panel Report 3 (EPR 3) was commissioned by the National Asthma Education and Prevention Program (NAEPP) Coordinating Committee (CC) and was coordinated by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health.
The panel used guidelines framed by EPR 2 in 1997 as well as the update of EPR 2 issued in 2004 as the basis for framing new asthma control guidelines.
The recommendations of the 18-member panel are centered on four main pillars of asthma management. These four pillars include:
* Measures of assessment and monitoring, obtained by objective tests, physical examination, patient history and patient report, to diagnose and assess the characteristics and severity of asthma and to monitor whether asthma control is achieved and maintained
* Education for a partnership in asthma care
* Control of environmental factors and co morbid conditions that affect asthma
* Medical or pharmacological management of the disease.
The new guidelines for asthma control focus on childhood asthma as well. Children are exposed to a lot of allergens during their formative years and are at a higher risk for asthma. The new guidelines have added an additional age group for children in that 5-11 year olds are included to the previous category of infants to 4 years old.
A third category focuses on children aged 12 or older. The new category has been added because studies show that children in this age group respond differently to medications than adults.
The guidelines stress on proper diagnosis and instituting a customized treatment plan that takes into account future risks as well.
They stress on:
* Functions of assessment and monitoring are closely linked to the concepts of severity, control, and responsiveness to treatment:
a) Severity: the intrinsic intensity of the disease process. Severity is measured most easily and directly in a patient not receiving long-term-control therapy.
b) Control: the degree to which the manifestations of asthma (symptoms, functional impairments, and risks of untoward events) are minimized and the goals of therapy are met.
c) Responsiveness: the ease with which asthma control is achieved by therapy.
* Both severity and control include the domains of current impairment and future risk:
a) Impairment frequency and intensity of symptoms and functional limitations the patient is experiencing or has recently experienced
b) Risk: the likelihood of either asthma exacerbations, progressive decline in lung function (or, for children, reduced lung growth), or risk of adverse effects from medications.
Monitoring asthma is the key, the guidelines stress. They say that doctors and patients themselves must assess the severity of symptoms being experienced daily. Dr. Elizabeth G. Nabel, director of the National Heart, Lung, and Blood Institute said doctors must take into account factors like future asthma attacks, loss of lung function and side effects from medication.
The treatment aspect is also touched upon. The panel says that the main aim for long-term asthma therapy must focus on:
* Reducing impairment
* Reducing risk
* A stepwise approach to pharmacologic therapy is recommended to gain and maintain control of asthma in both the impairment and risk domains
* Regular follow-up contacts at 1- to 6-month intervals, depending on level of control, are recommended to ensure that control is maintained and the appropriate adjustments in therapy are made: step up if necessary or step down if possible.
The guidelines also recommend the inclusion of the drug omalizumab in the overall therapy. This drug is a monoclonal antibody that fights immunoglobulin E, which is responsible for allergic reaction.
Controlling the severity of asthma is the most important aspect of treatment regimen for the disease. Patients must stay away from things that trigger attacks and must also be aware of the need to react quickly if they feel an attack is impending. As the guidelines say asthma control is indeed achievable, but patients must also play a role in controlling their disease.
 Add as favourites (34)
Powered by AkoComment Tweaked Special Edition v.1.4.4 |
Health 
