Asthma–Is Survival Good Enough?(Clinical Practice)

Asthma--Is Survival Good Enough?(Clinical Practice)

Advances in asthma management, particularly the introduction of controller medication of which inhaled corticosteroids are the most important, has resulted in a steady decline in asthma mortality in most countries. (1,2) This is usually accompanied by a decline in episodes of near-fatal asthma attacks and hospitalisations, and a reduction in other indicators of asthma morbidity. (1) These gains have led to a shift in thinking on the management of asthma, away from simply preventing death and hospitalisations, toward achieving and maintaining sustained control of all clinical features. This includes absence of daytime and night-time symptoms, no limitation of activities, no rescue [[beta].sub.2]-agonist use and normal lung function. (3) Recent research has confirmed that this goal is achievable in a large proportion of patients with asthma of all severities, (3) and new strategies have been devised to maintain these gains using the lowest effective treatment doses. (4-7) Cost-benefit analyses have confirmed the efficacy of this approach in that a large proportion of asthma costs result from unscheduled visits and use of health care resources, such that it has recently been suggested that we cannot ‘afford to not control asthma’, even when initial maintenance therapy appears to be more costly. (8)

Asthma--Is Survival Good Enough?(Clinical Practice)

Asthma–Is Survival Good Enough?(Clinical Practice) | | 4.5