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ANAHEIM, CALIF. -- Patients with uncontrolled asthma are seen more often by primary care providers (PCPs) than by allergists, but a survey has found that 42% of PCPs are unfamiliar [...]

ANAHEIM, CALIF.--Patients with uncontrolled asthma are seen more often by primary care providers (PCPs) than by allergists, but a survey has found that 42% of PCPs are unfamiliar with the [...]

For asthma patients, a careful assessment of functional impairment and risk for exacerbation is the most effective means of determining optimal treatment, according to extensive new guidelines from the National [...]

* OBJECTIVE Current guidelines recommend use of written action plans and peak flow monitoring as key components of asthma care. Our study assesses whether written action plans, with or without [...]

Asthma is a common illness in the United States[1] and a frequent reason for ambulatory medical visits.[2] The overall economic impact of asthma in the United States is estimated to [...], Background. The rising incidence of and mortality from asthma have prompted the development of practice guidelines for diagnosis and management. A cornerstone of these guidelines is the use of objective measures of asthma severity: spirometry or peak expiratory flow rates. We studied the extent to which primary care clinicians used objective measures of asthma severity. Methods. Practices affiliated with the Ambulatory Sentinel Practice Network in the United States and Canada collected data on 490 asthma-related encounters involving 439 patients. For each encounter, the practice recorded the availability of the results of spirometry, peak expiratory flow rates, oxygenation (arterial blood gas or pulse oximetry), and chest radiograph to the clinician. Results. Objective data about asthma severity were infrequently available to ASPN clinicians at the time of the encounter. In 67.8% of encounters, there was no current or past spirometry result, in 55.1% there was no current or past peak flow measurement, and in 74.3% there was no current or past determination of oxygenation. Chest radiographs, on the other hand, were available for most (64.7%) patients. The lack of objective measures was not related to lack of access to the relevant technologies. Most practices noted easy access to spirometry (72.2% of practices), peak flow meters (72.2%), oxygenation determination (61.1%), and radiography (83.3%). Conclusions. In this study, most primary care clinicians did not have objective data about the severity of their patients' asthma at the time of the encounter. This relative lack of objective data was not explained by lack of access to the relevant technology for determining severity. It may instead reflect the opinion of primary care physicians that such information is not necessary in the care of these patients. Key words. Asthma; spirometry; severity of illness; practice guidelines; research; family practice; practice-based research. (J Fam Pract 1995; 41:139-143)

Asthma and chronic obstructive pulmonary disease (COPD), eg, bronchitis and emphysema, afflict 24 million Americans; these patients spend more than $1 billion annually on treatment.(1) These chronic pulmonary diseases continue [...], This review addresses the use of the metered dose inhaler (MDI) to administer aerosol therapy in the treatment of asthma, bronchitis, and emphysema. Studies have shown that physician's prescribing patterns for use of the inhaler have been inconsistent with optimal therapy. Furthermore, the medical literature suggests that the metered dose inhaler should replace the jet nebulizer in hospital and outpatient settings as a more efficient and cost-effective treatment method. All classes of aerosol drugs are now available for administration by the MDI. Reports suggest that patients whose conditions do not respond to treatment administered by the MDI may improve following instruction in the proper method of using the inhaler or by increasing the recommended dosage of medication for those receiving β-adrenergic, anticholinergic, and glucocorticoid drugs. A consensus now recommends that aerosol glucocorticoids be considered the primary method of therapy for asthma; however, the effectiveness of glucocorticoids in the treatment of bronchitis and emphysema has not been determined. Although available data do not prove that drugs used in the treatment of asthma increase mortality, further study is recommended in view of potential toxicity of these drugs.

Effectively managing patients with allergies requires an understanding of the underlying science and the ability to apply these concepts. Keep in mind that allergy represents a tremendous opportunity for optometry. [...]

Flovent HFA Inhalation Aerosol (fluticasone propionate HFA, GlaxoSmithKline) The Food and Drug Administration approved Flovent HFA Inhalation Aerosol for prophylactic and maintenance treatment of asthma in adults and adolescents 12 [...]

A comprehensive school-based asthma management program resulted in significantly fewer daytime asthma symptoms, fewer asthma-related school absences, and better grades in science with outcomes evident up to 2 years after [...]

Foradil (formoterol fumarate inhalation powder) has been approved for the long-term maintenance in asthma and prevention of bronchospasm in adults and children aged 5 years and older. The twice-daily therapy, [...]

WASHINGTON -- Disease management programs continue to gain favor with health plans, but health-related behavior programs are still far from being smoothly integrated, Lisa A. Benz Scott, Ph.D., said at [...]

Are clinical guidelines making a difference in asthma care? Dr. Mark Dykewicz is director of the training program in allergy and immunlogy at St. Louis University. Treatment of asthma is [...]

HARBOR SPRINGS, MICH. -- You can't treat asthma successfully without accurately assessing its severity, Dr. Autumn Clos said at the scientific assembly of the Michigan Academy of Family Physicians. Referring [...]

Is outcomes management the best way to improve asthma care? YES In asthma management, as in medicine in general, greater reliance on measurement of outcomes is becoming inevitable as a [...]

Care coordinated through an asthma center reduced emergency room visits and hospitalizations in patients with difficult-to-control asthma, and improved the use of anti-inflammatory medications, a prospective study showed. Investigators at [...]

HARBOR SPRINGS, MICH. -- Primary care doctors treat 90% of asthma patients, and that's appropriate, Dr. Autumn Clos said at the scientific assembly of the Michigan Academy of Family Physicians. [...]

WASHINGTON -- The cost of asthma care rose by 54% over a recent 10-year period, fueled largely by a steep rise in medication costs, a new study has shown. The [...]

WASHINGTON -- The National Medical Association is taking on asthma. As part of a new initiative to fight a disease that disproportionately strikes ethnic minority populations, the NMA is about [...]

Mandelberg A, Tsehori S, Houri S, et al. Is nebulized aerosol treatment necessary in the pediatric emergency department? Comparison with a metal spacer device for metered-dose-inhaler. Chest 2000; 117:1309-13. * [...]

A metaanalysis of 24 studies of allergen-specific immunotherapy in 962 people with documented allergen-triggered asthma published between 1966 and 1998 'support the effectiveness of immunotherapy' in this population, said Robert [...]

WASHINGTON -- A user-friendly guide to management of pediatric asthma has been published on the Internet, but printed copies are not yet widely available. The publication, 'Pediatric Asthma: Promoting Best [...]

Clinical question Which types of homemade spacers are most effective for inhaled Β-agonist delivery in children with acute asthma exacerbations? Background Multiple studies have demonstrated that for acute asthma exacerbations, [...]

A helium-oxygen mixture is more effective than 30% oxygen in improving airflow obstruction and dyspnea in patients with acute severe asthma, said Dr. Jonathan E. Kass and Dr. Carol Terregino [...]

Hospitalization for Asthma Prolonging initial hospital stays for asthma treatment may prevent subsequent hospitalizations and thereby lower total treatment costs, said Richard Stanford, Pharm.D., of Glaxo Wellcome Research and Development [...]

A helium-oxygen mixture is more effective than 30% oxygen in relieving acute severe asthma, reported Dr. Jonathan E. Kass and Dr. Carol Terregino of Cooper Hospital/University Medical Center, Camden, N.J. [...]

Dietary supplements of beta carotene appear to provide some protection against exercise-induced asthma, said Dr. Ittai Neuman of Hasharon Hospital, Rabin Medical Center, Petach Tivka, Israel. In a study involving [...]

LAS VEGAS -- The National Medical Association is joining forces with the American Academy of Allergy, Asthma, and Immunology to develop a campaign to improve public awareness and medical treatment [...]

SAN DIEGO -- The Alair Bronchial Thermoplasty System produced significant improvements in quality of life in 79% of patients with severe asthma who underwent treatment, compared with 64% of sham [...]

Asmanex Twisthaler (mometasone furoate inhalation powder, Schering-Plough Corp.) The Food and Drug Administration approved Asmanex Twisthaler for once-daily maintenance treatment of asthma in children aged 4-11 years. The agency initially [...]

SAN FRANCISCO -- The phaseout of inhalers that use chlorofluorocarbons to deliver medication for asthma or lung disease will cost patients more because newer inhalers use patented instead of generic [...]

A panel of U.S. asthma experts hopes the first major overhaul of asthma diagnosis and management guidelines in a decade will leave more patients breathing easier. An emphasis on prevention [...]

Foradil Certihaler (formoterol fumarate inhalation powder, Novartis Pharmaceuticals) The Food and Drug Administration approved the Foradil Certihaler (formoterol fumarate inhalation powder) for long-term maintenance treatment of asthma and for the [...]

Long-acting [β.sub.2]-adrenergic agonists should not be the first medicine physicians prescribe for patients with asthma and should be added to treatment only when patients do not adequately respond to other [...]

ANAHEIM, CALIF. -- Despite being treated by asthma experts and receiving multiple state-of-the-art drugs, a ''shocking' number of patients with moderate to severe asthma remained poorly controlled in a large, [...]

Buteyko breathing is a form of slow, shallow breathing popular in some countries for controlling asthma symptoms. Its effects may relate to changes in patient perception of symptoms or to [...]

BOSTON -- Failing to recognize and appropriately treat anaphylaxis in all its guises can have fatal consequences for patients suffering an extreme allergic reaction, said Carlos A. Camargo, M.D. Many [...]

Woodcock A, Forster L, Matthews E, et al. Control of exposure to mite allergen and allergen-impermeable bed covers far adults with asthma. N Engl J Med 2003; 349:225-236. * PRACTICE [...]

Ho AM, Lee A, Karmakar MK, Dion PW, Chung DC, Contardi LH. Heliox vs air-oxygen mixtures for the treatment of patients with acute asthma: A systematic overview. Chest 2003; 123:882-890. [...]

MAUI, HAWAII -- Look for atopic dermatitis therapy to increasingly evolve in a direction parallel to asthma therapy's path since the early 1990s, Dr. Lawrence F. Fichenfield predicted at the [...]

Asthma is a complex or multifactorial condition in which environmental and genetic factors combine in as-of-yet poorly under stood ways to cause disease. Despite advances in diagnosis and treatment of [...]

Asthma is a complex or multifactorial condition in which genetic and environmental factors combine to cause disease in ways that are, as of yet, poorly understood. Despite advances in diagnosis [...]

SAN DIEGO -- The Alair Bronchial Thermoplasty System produced significant improvements in quality of life in 79% of patients with severe asthma who underwent treatment, compared with 64% of sham [...]

WASHINGTON -- The use of statins was associated with a 33% reduction in the risk of emergency department visits and hospitalizations among adult asthma patients in a retrospective study of [...]

Asthma affects 4%-8% of all pregnant women. Well-controlled asthma has been associated with favorable outcomes in pregnancy, but poorly controlled asthma has been associated with increased rates of preterm delivery, [...]

TORONTO -- Many patients with severe, refractory asthma are unable to control it well despite the availability of updated guidelines, even in subspecialty care, said Dr. Amandeep S. Gill of [...]

FORT LAUDERDALE, FLA. -- Ask patients in an open-minded way about their use of unconventional therapies related to asthma, allergies, and other pulmonary conditions. 'The take-home message is beware of [...]

TORONTO -- Treatment with a proton pump inhibitor did not improve asthma control in patients with poorly controlled asthma and minimal or no symptoms of gastroesophageal reflux, according to results [...]

TORONTO -- A substantial proportion of patients with severe refractory asthma are unable to become well controlled despite the availability of updated guidlines, even in subspecialty care, according to Dr. [...]

TORONTO -- Treatment with a proton pump inhibitor did not improve asthma control in patients with poorly controlled asthma and minimal or no symptoms of gastroesophageal reflux, according to results [...]

FORT LAUDERDALE, FLA. -- Ask patients in an open-minded way about their use of unconventional therapies related to asthma, allergies, and other pulmonary conditions. 'The take-home message is 'beware of [...]