asthma
ASTHMA
Asthma is a chronic inflammatory disease of the airways in the lungs of children and adults.
The patient usually complains of shortness of breath, chest tightness and coughing with wheezing.
Goals of treatment are effective symptom control with minimal or no exacerbations, minimal or no nocturnal and daytime symptoms, no limitations on activities, minimal or no need for reliever treatment, and minimal adverse effects of medication.

Patient Education

  • Goal: Increase understanding, skills, satisfaction & confidence to increase compliance & self-management of asthma
  • Develop partnership between healthcare professionals, patient & the patient’s family
  • Continual process to provide the patient & their family with appropriate information & training to allow the patient to remain well & modify therapy according to predetermined medication plan
    • Plan includes specific information about medication and dosage changes based on symptoms &/or peak expiratory flow (PEF) and when and how to access medical care
  • Education should be provided over several visits
    • Inquire also about patient’s compliance to the treatment plan & their ways of avoiding risk factors
  • Improve compliance: The patient is more likely to be compliant with medicine regimens if:
    • The diagnosis is accepted & the patient realizes that asthma can be dangerous or can be a problem
    • The patient believes the treatment is safe
    • The patient feels in control & there is good communication between the patient & provider
  • Healthcare professionals should help patients to recognize deterioration in asthma control & should educate patients to seek medical attention if:
    • There is severe asthma attack & respiratory distress (ie severe dyspnea, difficulty talking)
    • Reliever medication is needed more than every 4 hours & symptoms are still not improving

Self-Monitoring

  • If possible & based on resources of the healthcare system, on the initial visit, concept of peak expiratory flow (PEF) monitoring may be introduced to the motivated patient
    • Patients with more than mild disease should receive training on how to measure & record peak expiratory flow (PEF)
  • Self monitoring is not reliable in children
  • If peak expiratory flow (PEF) monitoring is not an option, patient should be educated to assess their status based on symptoms
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12 Apr 2019
Long-acting beta2-agonist (LABA) plus long-acting muscarinic antagonist (LAMA) combinations compare with inhalers containing both LABA and corticosteroid (LABA-ICS) in terms of reducing chronic obstructive pulmonary disease (COPD) exacerbations, although the LAMA-LABA combination is more favourable as it is associated with fewer episodes of severe pneumonia, according to a study.
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