The management of chronic asthma

Published on January 31, 2013   32 min

A selection of talks on Clinical Practice

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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.
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.
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.
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.
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,