Poor asthma control in clinical practice: quantifying the perspective of improvement
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Pneumon 2008;21(3):283-292
summArY. In spite of the development and circulation of international guidelines for the diagnosis and treatment of asthma during recent years, there is evidence of uncontrolled asthma and poor control of asthma among children and adults. According to the most recent guidelines for the treatment of asthma, the aim of asthma management is to achieve and maintain control, for as long as possible, without having side-effects from medication. However, “asthma control” has a different significance for different people. For many years, the effectiveness of the treatment for asthma was measured by isolated parameters, such as symptoms, lung function, exacerbations, surrogate markers of inflammation or the need for reliever medication. In clinical practice, healthcare professionals have monitored patients, evaluating the severity of the disease and treating the symptoms. However, there is no evidence that any of these parameters that have been used indicates the achievement of control. Moreover, they do not reflect what is important for the patient, whose quality of life depends on the pervasiveness of the disease and not on isolated signs of improvement. The fact that the level of asthma control is often overestimated by patients and doctors alike suggests that the guidelines alone are not sufficient to ensure an adequate measurement of the level of asthma control. This review aims to highlight the commonest reasons for poor asthma control and to propose solutions for raising the perspectives of improvement. Pneumon 2008; 21(3):283–292
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