Canadian Thoracic Society Asthma Management Continuum – 2010 Consensus Summary for Children Six Years of Age and Over, and Adults

Lougheed, M. Diane; Lemière, Catherine; Dell, Sharon; Ducharme, Francine M; FitzGerald, J. Mark; Leigh, Richard; Licskai, Chris; Rowe, Brian H.; Bowie, Dennis; Becker, Allan B.; Boulet, Louis‐Philippe

doi:10.1155/2010/827281

Cited by 172 publications

(228 citation statements)

References 59 publications

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“…Most asthma guidelines suggest that a WAAP developed in partnership with patients is an essential tool that helps patients respond appropriately to changes in asthma status (1)(2)(3). However, the most recent Expert Panel Report-3 of the National Asthma Education and Prevention Program (NAEPP) acknowledges that the recommendation to "provide all patients with a written asthma action plan that includes instructions for daily management and recognizing and handling worsening asthma" (1) is based on a limited body of evidence with few randomized controlled trials that involve substantial numbers of participants (1).…”

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confidence: 99%

Do Patients of Subspecialist Physicians Benefit from Written Asthma Action Plans?

DiMango

et al. 2015

Am J Respir Crit Care Med

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Rationale: Asthma clinical guidelines suggest written asthma action plans are essential for improving self-management and outcomes.Objectives: To assess the efficacy of written instructions in the form of a written asthma action plan provided by subspecialist physicians as part of usual asthma care during office visits.Methods: A total of 407 children and adults with persistent asthma receiving first-time care in pulmonary and allergy practices at 4 urban medical centers were randomized to receive either written instructions (n = 204) or no written instructions other than prescriptions (n = 203) from physicians.Measurements and Main Results: Using written asthma action plan forms as a vehicle for providing self-management instructions did not have a significant effect on any of the primary outcomes: (1) asthma symptom frequency, (2) emergency visits, or (3) asthma quality of life from baseline to 12-month follow-up. Both groups showed similar and significant reductions in asthma symptom frequency (daytime symptoms [P , 0.0001], nocturnal symptoms [P , 0.0001], b-agonist use [P , 0.0001]). There was also a significant reduction in emergency visits for the intervention (P , 0.0001) and control (P , 0.0006) groups. There was significant improvement in asthma quality-of-life scores for adults (P , 0.0001) and pediatric caregivers (P , 0.0001).Conclusions: Our results suggest that using a written asthma action plan form as a vehicle for providing asthma management instructions to patients with persistent asthma who are receiving subspecialty care for the first time confers no added benefit beyond subspecialtybased medical care and education for asthma.Clinical trial registered with www.clinicaltrials.gov (NCT 00149461).

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confidence: 99%

Do Patients of Subspecialist Physicians Benefit from Written Asthma Action Plans?

DiMango

et al. 2015

Am J Respir Crit Care Med

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“…The use of intranasal steroids and systemic steroids by some of our patients is a possible confounder. However, the use of intranasal corticosteroids has not been shown to decrease endogenous cortisol levels more than the use of ICS alone (6); and short-course systemic corticosteroid therapy for the treatment of asthma, as recommended by asthma treatment guidelines (19), was not associated with long-term suppression of adrenal function (20,21). Furthermore, a hair cortisol analysis has the advantage of representing an overall picture of adrenal cortisol production and function of the HPA, rather than indicating acute or short-term fluctuations.…”

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confidence: 99%

Hair cortisol as a novel biomarker of HPA suppression by inhaled corticosteroids in children

et al. 2015

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Background: Asthma is the most common chronic condition in childhood, and the recommended pharmacotherapy for long-term control includes the use of inhaled corticosteroids (ICS). ICS were designed to act at the site of inflammation in the lung, thus decreasing systemic absorption and reducing the risk of adverse effects associated with corticosteroid use (e.g., HPA suppression and its consequent effects). Available data show that measurement of hair cortisol successfully reflects endogenous cortisol levels. We sought to examine whether hair cortisol measurements can be used to identify HPA suppression surrounding ICS therapy in children with asthma. Methods: Hair samples were collected from the vertex posterior region of the head of 18 asthmatic children. We compared their hair cortisol concentration during ICS use with the concentration prior to ICS use. results: During ICS therapy, median hair cortisol levels were twofold lower compared with the period of no ICS use (median 89.8 ng/g vs. 198.2 ng/g, P = 0.0015). conclusion: Hair cortisol is an effective biomarker of the HPA suppression associated with ICS therapy and can be a sensitive tool for determining systemic effects of ICS use and monitoring adherence. Future research is needed to characterize the effect of untreated asthma on hair cortisol concentrations, if any.

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“…5,7,8 Spirometry is the preferred objective measure to assess for reversible airway obstruction (i.e., rapid improvement in lung function after inhalation of a rapid-acting bronchodilator) and to confirm a diagnosis of asthma. It is recommended for all patients over 6 years of age who are able to undergo lung function testing.…”

Section: Introductionmentioning

confidence: 99%

“…It is recommended for all patients over 6 years of age who are able to undergo lung function testing. 5,7 Spirometry measures the forced vital capacity (FVC, the maximum volume of air that can be exhaled) and the forced expiratory volume in 1 second (FEV1). The ratio of FEV1 to FVC provides a measure of airflow obstruction.…”

Section: Introductionmentioning

confidence: 99%

The relationship between vitamin D level and severity and control of bronchial asthma among adult Sudanese patients

Mustafa¹,

Elhag

Abukanna

et al. 2018

Int J Res Med Sci

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Background: The aim of this study was to assess the relationship between vitamin D level and severity and control of bronchial asthma among adult Sudanese patients at Alshaab Teaching Hospital.Methods: This prospective cross-sectional study, conducted at Alshaab Teaching Hospital, Khartoum Sudan in the period from June to August 2015. Eighty-six asthmatic patients participated in the study after taking their consent. Demographic data were collected using structured questionnaire, the clinical parameters of asthma severity and control were measured according to the criteria of Global Strategy for Asthma Management and Prevention 2014 of the Global Initiative for Asthma (GINA). Airway limitation was assessed using Peak Flow Meter. Three ml of blood was taken from each patient to measure vitamin D (25(OH)D) using enzyme-linked immunosorbent assay (ELISA) and data were analyzed using the statistical package for social science (SPSS) version 20.Results: Normal serum 25(OH)D (30-50ng/ml) was found in only 2.3% of patients. The mean serum 25(OH)D level in patients with controlled asthma was 25.82±17.27ng/ml while in patients with uncontrolled asthma it was16.48±7.14ng/ml. (P value = 0.005). The mean serum 25(OH)D level in patients with severe asthma was 16.15±6.9ng/ml (P value = 0.151).Conclusions: There was a positive correlation between vitamin D level and bronchial asthma control and a negative correlation with bronchial asthma severity among the study group.

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Canadian Thoracic Society Asthma Management Continuum – 2010 Consensus Summary for Children Six Years of Age and Over, and Adults

Cited by 172 publications

References 59 publications

Do Patients of Subspecialist Physicians Benefit from Written Asthma Action Plans?

Do Patients of Subspecialist Physicians Benefit from Written Asthma Action Plans?

Hair cortisol as a novel biomarker of HPA suppression by inhaled corticosteroids in children

The relationship between vitamin D level and severity and control of bronchial asthma among adult Sudanese patients

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