Therapy of acute asthma

McFadden, E. R.

doi:10.1016/0091-6749(89)90318-7

Cited by 32 publications

(3 citation statements)

References 48 publications

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“…The early suggestion that use of a pMDI with a pMDI accessory device might help to overcome some issues with poor inhaler competence (19) has garnered some support. Fewer errors in inhalation technique (20) and a reduction in the number of incorrect administrations (21) were observed in patients using a pMDI with VHC compared with a pMDI alone.…”

Section: Impact Of Poor Inhaler Competencementioning

confidence: 99%

Emerging Technologies for Electronic Monitoring of Adherence, Inhaler Competence, and True Adherence

Pritchard

Nicholls²

2015

Journal of Aerosol Medicine and Pulmonary Drug Delivery

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Despite the availability of effective treatments for respiratory disorders, disease control is often suboptimal, due in part to the failure of patients to adhere to prescribed regimens, or to demonstrate competence with the often complex steps in the administration of inhaled medications. The cost of poor true adherence, a combined measure of adherence and inhaler competence, is considerable, both economically and in terms of health-related impact. While patient education is recognized as essential, there exist many barriers to healthcare professional-led monitoring and promotion of true adherence. Successful intervention remains a challenging task, dependent upon understanding and addressing the distinct issues associated with poor adherence and inhaler competence, and lessening the perceived burden on healthcare professionals. Electronic monitors provide an accurate and objective indication of adherence and may also be of value in assessing inhaler competence. The information provided by such devices is a helpful aid to understanding the challenging nature of true adherence, and may be crucial to the development and assessment of true adherence promoting interventions. This article provides a background to the impact of suboptimal adherence and inhaler competence, and the challenges associated with the promotion of true adherence, with an emphasis on respiratory therapies. Contemporary electronic monitors of adherence and inhaler competence are critically reviewed, and case studies of emerging technologies are provided to illustrate the use of innovative monitoring devices in the promotion of true adherence in practice. Potential future directions, including increased targeting and individualization, enhanced coordination of care, and a greater focus on inhaler competence are considered to be important additions to currently available technologies in this rapidly evolving field.

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Section: Impact Of Poor Inhaler Competencementioning

confidence: 99%

Emerging Technologies for Electronic Monitoring of Adherence, Inhaler Competence, and True Adherence

Pritchard

Nicholls²

2015

Journal of Aerosol Medicine and Pulmonary Drug Delivery

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“…Sólo tres cuartas partes de la serie recibió la combinación terapéutica convencional recomendada para estos casos, es decir: Esteroides sistémicos β 2 agonistas en nebulización y aminofilina (1,2,8,13). Es indispensable emplear una combinación terapéutica que incluya un esteroide sistémico para el control del fenómeno inflamatorio y broncodilatadores eficaces para el control de los síntomas como la aminofilina y el β 2 agonista en nebulización ya que el cuadro de status asmático debe ser revertido lo más pronto posible con la finalidad de evitar deterioro clínico y funcional que lleve a la necesidad de ventilación mecánica o eventualmente a la muerte.…”

Section: Discusionunclassified

Manejo del status asmático en un hospital nacional: Estudio auditor en 50 pacientes.

López¹,

Castro²

2013

Rev Med Hered

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SUMMARYFifty acute asthma patients management was audited propectively in a national hospital. Mean age was 46 + 15 years and hospital stay 9 + days. The paradoxical pulse was measured in 2 (8%) patients and use of accessory muscles described in 4 (8%). Peak flow meter or spirometer measurement were not done in any patient. The treatment during hospital stay included combination of systemic corticosteroids aminophylline and nebulized fenoterol in 37 patients and antibiotics prescribed was not justified in 25 (88%) cases. The use of oxigen was registred in 27 (54%) patients. At discharge only 22 (44%) recieved oral corticosteroids and 5 (10%) a metered dose bronchodilator inhaler. We found serious deficiency in the hospitalary management and treatment of asthma patients that must be corrected. We advise to design a management protocol for this frequent disease. (Rev Med Hered 1992; 3: 153-156) KEY WORDS: Acute asthma, asthma treatment, medical audit asthma hospitalization. RESUMENSe evaluaron prospectivamente 50 historias clínicas en el mismo número de pacientes hospitalizados por status asmático. La edad media fue de 46 + 15 años y el tiempo de hospitalización 9 + 6 días. El pulso paradojal fue medido en 2 (4%) casos y el uso de musculatura accesoria descrito en 4 (8%), asimismo la presencia de sibilantes en 50 (100%). No se practicaron pruebas funcionales respiratorias. Tres cuartas partes de la población recibieron la modalidad terapéutica recomendada de esteroides sistémico-β2 agonistasaminofilina. Los antibióticos estuvieron injustificadamente indicados en 25 (88%) casos y 27 (54%) pacientes tenían anotada la indicación de oxígeno en la hoja terapéutica. Al alta hospitalaria sólo 22 (44%) casos recibieron esteroides por vía oral y 5 (10%) B2 agonistas en forma de inhalador. La muestra evaluada destaca deficiencias notables en el manejo y tratamiento intrahospitalario del status asmático que requieren ser enmendadas. Recomendamos diseñar un protocolo rígido de manejo para esta condición respiratoria. (Rev Med Hered 1992; 3:153-156) PALABRAS CLAVE: Asma aguda, asma tratamiento, auditoria médica, asma hospitalización.

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“…Inadequate management of asthma in the hospital emergency department (ED) has been recognized for many years (1)(2)(3)(4)(5). In the United States each year, nearly 2 million patients are seen for asthma exacerbations in the ED (6).…”

Section: Introductionmentioning

confidence: 99%

Asthma Treatment Protocols in the Emergency Department: Are They Effective?

et al. 2007

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Management of asthma in emergency departments (ED) has been well documented to be deficient over many years, despite national and international guidelines. This review summarizes the effect of ED protocols aimed at improving the assessment and treatment of asthma in the ED. We performed a PubMed search of the English literature for ED asthma protocols published from 1986 to 2006 and identified 11 studies. Protocols were effective in improving at least some areas of management, including use of appropriate patient assessment, drug therapy per national guidelines, and patient education. A small number of protocols with the specific aims of reducing the length of stay in the ED as well as rates of hospital admission and return visits were effective. Persistent education of ED staff regarding protocols based on current management guidelines and adoption of easy-to-use forms can facilitate improved care of patients with asthma in the ED.

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Therapy of acute asthma

Cited by 32 publications

References 48 publications

Emerging Technologies for Electronic Monitoring of Adherence, Inhaler Competence, and True Adherence

Emerging Technologies for Electronic Monitoring of Adherence, Inhaler Competence, and True Adherence

Manejo del status asmático en un hospital nacional: Estudio auditor en 50 pacientes.

Asthma Treatment Protocols in the Emergency Department: Are They Effective?

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