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Printable Handouts
Navigable Slide Index
- Introduction
- Conflicts of interest
- Learning objectives
- Benefits of clear asthma management strategy
- GINA 2006: levels of asthma control (1)
- Asthma management continuum
- Asthma control in Canada
- GINA 2006: levels of asthma control (2)
- Simplified management based upon control
- Initial treatment in mild asthma
- Early intervention with budesonide
- Compliance to ICS therapy can prevent deaths
- Exacerbations requiring oral steroids
- Initial treatment of asthma
- Add-on therapies
- The risk:benefit ratios of ICS
- Available ICS + LABA single-inhaler combinations
- Well controlled asthma with sustained treatment
- The STAY study
- STAY: study design
- SMART increased time to severe exacerbation
- Severe exacerbations
- Need for systemic steroids
- MF/F therapy delayed time to deterioration
- Asthma control: current control and future risk
- JACI 2010 - design
- JACI 2010 - results
- Fixed dose versus SMART
- Exacerbations and sputum eosinophil counts
- Sputum eosinophil counts: RCT design
- Current control and future risk
- A window of opportunity
- The people in your practice
- Many switched/discontinued maintenance therapy
- Acute treatment for asthma in past year
- Stopped taking controller in past year
- Attitudes about asthma and its treatment
- Actual and perceived asthma control
- Family physicians' knowledge of asthma control
- Asthma control: a comprehensive concept
- Strategies to engage patients for better control
- Asthma exacerbations increase future risk
- Future exacerbations and recent exacerbations
- Asthma exacerbations association with costs
- Lung function by asthma and smoking status
- Factors contributing to airway remodeling
- Loss of lung function and severe exacerbations
- Anti-IgE omalizumab
- Reduction in asthma exacerbations
- Time to first asthma exacerbation
- Criteria for Omalizumab administration
- Blockbuster drug for asthma
- Self management effect on hospitalizations
- Effect of optimal self management on ED visits
- Asthma education and monitoring (1)
- Asthma education and monitoring (2)
- Asthma education
- Conclusions
- Acknowledgment
Topics Covered
- Importance of reviewing patient's history
- Identification of potential environmental factors
- Patients with uncontrolled asthma may require anti-inflammatory medications with inhaled corticosteroids (ICS) being the standard treatment
- Asthmatics on ICS with uncontrolled asthma may require adjunct therapy such as a long acting beta agonist and or a leukotriene antagonist
- Education program and written action plan
Links
Series:
Categories:
Therapeutic Areas:
Talk Citation
Fitzgerald, M. (2013, January 31). The management of chronic asthma [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved October 11, 2024, from https://doi.org/10.69645/DARF1876.Export Citation (RIS)
Publication History
Financial Disclosures
- Prof. Mark Fitzgerald has not informed HSTalks of any commercial/financial relationship that it is appropriate to disclose.
A selection of talks on Clinical Practice
Transcript
Please wait while the transcript is being prepared...
0:00
Welcome to the Institute
for Heart and Lung Health
at the University of
British Columbia.
This presentation will focus
on the management
of chronic asthma.
My name is Mark FitzGerald.
I'm a Professor of
Respiratory Medicine
at the University of
British Columbia.
0:16
Before I begin,
I'd like to indicate to
you that I have conflicts
of interest with the
companies and agencies
listed on the current slide.
0:26
The objectives for the
presentation today are:
to define the current
guideline-based asthma management,
understand the consequences
of poor asthma control
and future risk,
and prevent these consequences
through improved disease control.
These objectives will be
achieved by showing you
how to employ
individualized strategies
and treatment options to enhance
patient adherence to therapy
and achieve better
asthma control.
0:53
Asthma guidelines have
provided a framework for us
in which we can manage asthma.
In this editorial,
published in The Lancet
in September 2010,
we outlined the
benefits of having
a clear evidence-based strategy
for the management of asthma.
1:10
In this slide, we see
a number of control
criteria outlined.
On the left-hand side,
we can see these criteria
focusing on daytime symptoms,
limitations of activities,
nocturnal symptoms
and awakening,
need for rescue medication,
and lung function and as
well as exacerbation.
We can see that
patients' asthma control
can be divided into a number of
different levels of control.
Controlled asthma, partly
controlled asthma,
when any of these features are
present in a previous week,
and then uncontrolled asthma,
where three or more features
of partly controlled asthma
are present in any one week.
We can see here that although
we aim for controlled asthma,
in many cases, we can only
achieve partly
controlled asthma.
In this animation of the
asthma management continuum,