Τίτλος:
Reducing the hidden burden of severe asthma: recognition and referrals from primary practice
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Since their introduction many decades ago, systemic corticosteroids have become a mainstay treatment for asthma. Despite being a highly effective therapy, corticosteroids can cause significant adverse effects in patients. This results in a “double hit” for some patients as they suffer the burden of disease as well as the burden of treatment-induced morbidity. This article aims to raise awareness of the potential, harmful side effects of prolonged or repeated exposure to systemic corticosteroids in asthma. It also highlights the importance of referral of the appropriate patients with asthma from primary care for specialist assessment once other considerations such as adherence, inhaler technique and co-morbidity have been evaluated. We propose a simple decision step that may help busy primary care physicians and general practitioners to identify patients who could benefit from specialist assessment. Our decision step suggests that a patient with asthma should be reviewed at least once by an asthma specialist if he/she (i) has received ≥2 courses of oral corticosteroids in the previous year; asthma remains uncontrolled despite good adherence and inhaler technique; or (ii) has attended an emergency department or was hospitalized for asthma care. Such referral could facilitate wider access to diagnostic tools, in-depth assessment of confounding comorbidities, and non-corticosteroid-based therapies as needed, which may be unavailable in primary practice. © 2020 Taylor & Francis Group, LLC.
Συγγραφείς:
Humbert, M.
Bourdin, A.
Papadopoulos, N.G.
Holgate, S.T.
Hanania, N.A.
Halpin, D.M.G.
Chapman, K.R.
Gavornikova, M.
Price, D.B.
Kaplan, A.
Heaney, L.G.
Περιοδικό:
Journal of Asthma
Εκδότης:
Taylor and Francis Ltd.
Λέξεις-κλειδιά:
clinical decision making; general practitioner; human; medical specialist; Note; patient referral; primary medical care; severe asthma; asthma; attitude to health; chronic disease; comorbidity; medication compliance; organization and management; patient referral; primary health care; severity of illness index; specialization, corticosteroid, Adrenal Cortex Hormones; Asthma; Chronic Disease; Comorbidity; Health Knowledge, Attitudes, Practice; Humans; Medication Adherence; Primary Health Care; Referral and Consultation; Severity of Illness Index; Specialization
DOI:
10.1080/02770903.2020.1759084
