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management of exacerbation of asthma adult

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https://www.readbyqxmd.com/read/27905186/severe-asthma-current-management-targeted-therapies-and-future-directions-a-roundtable-report
#1
REVIEW
Vanessa M McDonald, Steven Maltby, Helen K Reddel, Gregory G King, Peter A B Wark, Lorraine Smith, John W Upham, Alan L James, Guy B Marks, Peter G Gibson
Asthma is a chronic respiratory disease characterized by respiratory symptoms, airway inflammation, airway obstruction and airway hyper-responsiveness. Asthma is common and directly affects 10% of Australians, 1-5% of adults in Asia and 300 million people worldwide. It is a heterogeneous disorder with many clinical, molecular, biological and pathophysiological phenotypes. Current management strategies successfully treat the majority of patients with asthma who have access to them. However, there is a subset of an estimated 5-10% of patients with asthma who have severe disease and are disproportionately impacted by symptoms, exacerbations and overall illness burden...
November 30, 2016: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/27822075/health-care-resource-use-and-costs-associated-with-possible-side-effects-of-high-oral-corticosteroid-use-in-asthma-a-claims-based-analysis
#2
Allan T Luskin, Evgeniya N Antonova, Michael S Broder, Eunice Y Chang, Theodore A Omachi, Dennis K Ledford
BACKGROUND: The objective of this study was to estimate the prevalence of possible oral corticosteroid (OCS)-related side effects and health care resource use and costs in patients with asthma. METHODS: This was a cross-sectional, matched-cohort, retrospective study using a commercial claims database. Adults with asthma diagnosis codes and evidence of asthma medication use were studied. Patients with high OCS use (≥30 days of OCS annually) were divided into those who did versus those who did not experience OCS-related possible side effects...
2016: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/27783268/fixed-dose-combination-inhalers
#3
Mario Cazzola, Maria Gabriella Matera
In asthma and chronic obstructive pulmonary disease (COPD), an important step in simplifying management and improving adherence with prescribed therapy is to reduce the dose frequency to the minimum necessary to maintain disease control. Fixed-dose combination (FDC) therapy might enhance compliance by decreasing the number of medications and/or the number of daily doses. Furthermore, they have the potential for enhancing, sensitizing, and prolonging the effects of monocomponents. Combination therapy with an inhaled corticosteroid (ICS) and a long-acting β-agonist (LABA) is considered an important approach for treating patients with asthma and patients with severe COPD who have frequent exacerbations...
October 26, 2016: Handbook of Experimental Pharmacology
https://www.readbyqxmd.com/read/27773852/u-biopred-clinical-adult-asthma-clusters-linked-to-a-subset-of-sputum-omics
#4
Diane Lefaudeux, Bertrand De Meulder, Matthew J Loza, Nancy Peffer, Anthony Rowe, Frédéric Baribaud, Aruna T Bansal, Rene Lutter, Ana R Sousa, Julie Corfield, Ioannis Pandis, Per S Bakke, Massimo Caruso, Pascal Chanez, Sven-Erik Dahlén, Louise J Fleming, Stephen J Fowler, Ildiko Horvath, Norbert Krug, Paolo Montuschi, Marek Sanak, Thomas Sandstrom, Dominic E Shaw, Florian Singer, Peter J Sterk, Graham Roberts, Ian M Adcock, Ratko Djukanovic, Charles Auffray, Kian Fan Chung
BACKGROUND: Asthma is a heterogeneous disease in which there is a differential response to asthma treatments. This heterogeneity needs to be evaluated so that a personalized management approach can be provided. OBJECTIVES: We stratified patients with moderate-to-severe asthma based on clinicophysiologic parameters and performed an omics analysis of sputum. METHODS: Partition-around-medoids clustering was applied to a training set of 266 asthmatic participants from the European Unbiased Biomarkers for the Prediction of Respiratory Diseases Outcomes (U-BIOPRED) adult cohort using 8 prespecified clinic-physiologic variables...
October 20, 2016: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/27762515/a-cross-sectional-cohort-analyses-assessing-response-to-levosalbutamol-bronchodilatory-cough-formulations-in-outpatient-community-settings-of-india-bus-analyses
#5
A Vora, Amit Bhargava
INTRODUCTION: Cough is significant health problem with greater implication for impaired quality of life. Acute and chronic cough due to infective (viral/bacterial), allergic conditions or bronchial asthma including cough variant asthma are often treated with combination of mucolytics, expectorants and bronchodilators. Bronchodilators reduces cough sensitivity, promotes clearance of cough secretions while reducing protrusive inflammatory mediator release. AIMS AND OBJECTIVES: To further understand the clinical utility and safety of Bronchodilatory cough formulations (BCF) containing Levosalbutamol in real world settings...
September 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27755160/improving-adherence-to-asthma-medications-current-knowledge-and-future-perspectives
#6
Kathryn V Blake
PURPOSE OF REVIEW: Poor adherence to asthma controller medications, particularly inhaled corticosteroids, has been well known for decades and is a major cause of uncontrolled asthma and increased healthcare utilization. This review presents recent evidence on factors leading to nonadherence in specific age groups, parents of young children, adolescents and young adults, adults, and the elderly. Novel management strategies including electronic sensors with associated smart phone applications for adherence improvement are discussed...
January 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/27748630/pharmacokinetics-pharmacodynamics-and-clinical-efficacy-of-omalizumab-for-the-treatment-of-asthma
#7
Maxime Luu, Marc Bardou, Philippe Bonniaud, Françoise Goirand
Omalizumab is a subcutaneously administrated monoclonal anti-IgE antibody indicated in adults, adolescents and children 6 years of age and older with moderate to severe allergic asthma uncontrolled by conventional pharmacological treatments and sensitization to at least one perennial allergen. Area covered: This drug evaluation summarizes published data on pharmacokinetic and pharmacodynamic properties of omalizumab, on clinical efficacy and safety, including real-world evidence, and provides a medico-economic evaluation of the drug...
December 2016: Expert Opinion on Drug Metabolism & Toxicology
https://www.readbyqxmd.com/read/27737713/fourfold-asthma-study-fast-a-study-protocol-for-a-randomised-controlled-trial-evaluating-the-clinical-cost-effectiveness-of-temporarily-quadrupling-the-dose-of-inhaled-steroid-to-prevent-asthma-exacerbations
#8
Andrew Skeggs, Tricia McKeever, Lelia Duley, Eleanor Mitchell, Lucy Bradshaw, Kevin Mortimer, Samantha Walker, Steve Parrott, Andrew Wilson, Ian Pavord, Chris Brightling, Mike Thomas, David Price, Graham Devereux, Bernard Higgins, Tim Harrison, Rebecca Haydock
BACKGROUND: Asthma is one of the commonest chronic diseases in the UK. Acute exacerbations of asthma are unpredictable, disruptive and frightening. They cause considerable morbidity and account for a large component of the health service costs of asthma. The widespread use of an asthma self-management plan, designed to encourage disease monitoring and timely intervention, can reduce exacerbations and is, therefore, recommended for all patients with asthma. Unfortunately, the majority of patients are not provided with such a plan...
October 13, 2016: Trials
https://www.readbyqxmd.com/read/27694279/the-use-of-mobile-applications-to-support-self-management-for-people-with-asthma-a-systematic-review-of-controlled-studies-to-identify-features-associated-with-clinical-effectiveness-and-adherence
#9
Chi Yan Hui, Robert Walton, Brian McKinstry, Tracy Jackson, Richard Parker, Hilary Pinnock
OBJECTIVES: Telehealth is promoted as a strategy to support self-management of long-term conditions. The aim of this systematic review is to identify which information and communication technology features implemented in mobile apps to support asthma self-management are associated with adoption, adherence to usage, and clinical effectiveness. METHODS: We systematically searched 9 databases, scanned reference lists, and undertook manual searches (January 2000 to April 2016)...
October 2, 2016: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/27595415/vitamin-d-for-the-management-of-asthma
#10
Adrian R Martineau, Christopher J Cates, Mitsuyoshi Urashima, Megan Jensen, Alex P Griffiths, Ulugbek Nurmatov, Aziz Sheikh, Chris J Griffiths
BACKGROUND: Several clinical trials of vitamin D to prevent asthma exacerbation and improve asthma control have been conducted in children and adults, but a meta-analysis restricted to double-blind, randomised, placebo-controlled trials of this intervention is lacking. OBJECTIVES: To evaluate the efficacy of administration of vitamin D and its hydroxylated metabolites in reducing the risk of severe asthma exacerbations (defined as those requiring treatment with systemic corticosteroids) and improving asthma symptom control...
September 5, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27582089/vilanterol-and-fluticasone-furoate-for-asthma
#11
Kerry Dwan, Stephen J Milan, Lynne Bax, Nicola Walters, Colin Powell
BACKGROUND: Vilanterol (VI) is a long-acting beta2-agonist (LABA) that binds to the beta2-adrenoceptor on the airway smooth muscle, producing bronchodilation. LABA therapy, which is well established in adults as part of the British Thoracic Society (BTS) Guidelines for the Management of Asthma, leads to improvement in symptoms and lung function and reduction in exacerbations. At present, the commonly used LABAs licensed for use in asthma management (formoterol and salmeterol) require twice-daily administration, whereas VI is a once-daily therapy...
September 1, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27580628/exhaled-nitric-oxide-levels-to-guide-treatment-for-adults-with-asthma
#12
Helen L Petsky, Kayleigh M Kew, Cathy Turner, Anne B Chang
BACKGROUND: Asthma guidelines aim to guide health practitioners to optimise treatment for patients so as to minimise symptoms, improve or maintain good lung function, and prevent acute exacerbations or flare-ups. The principle of asthma guidelines is based on a step-up or step-down regimen of asthma medications to maximise good health outcomes using minimum medications. Asthma maintenance therapies reduce airway inflammation that is usually eosinophilic. Tailoring asthma medications in accordance with airway eosinophilic levels may improve asthma outcomes such as indices of control or reduce exacerbations or both...
September 1, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27564130/cost-effectiveness-and-budget-impact-of-routine-use-of-fractional-exhaled-nitric-oxide-monitoring-for-the-management-of-adult-asthma-patients-in-spain
#13
L Sabatelli, U Seppälä, J Sastre, G Crater
OBJECTIVES: Fractional exhaled nitric oxide (FeNO) is a marker for Type-2 airway inflammation. The objective of this study was to evaluate cost-effectiveness and budget impact of FeNO monitoring for management of adult asthma in Spain. METHODS: Cost-effectiveness model analysis was used to evaluate the economic outcomes when asthma management was assisted with FeNO monitoring. Over a one-year period, the model estimated the incremental cost per quality-adjusted life year (QALY) and incremental number of exacerbations avoided when FeNO monitoring was added to standard guideline-driven asthma care and compared to standard care alone...
August 26, 2016: Journal of Investigational Allergology & Clinical Immunology
https://www.readbyqxmd.com/read/27507234/impact-of-omalizumab-on-treatment-of-severe-allergic-asthma-in-uk-clinical-practice-a-uk-multicentre-observational-study-the-apex-ii-study
#14
Robert M Niven, Dinesh Saralaya, Rekha Chaudhuri, Matthew Masoli, Ian Clifton, Adel H Mansur, Victoria Hacking, Susan McLain-Smith, Andrew Menzies-Gow
OBJECTIVE: To describe the impact of omalizumab on asthma management in patients treated as part of normal clinical practice in the UK National Health Service (NHS). DESIGN: A non-interventional, mixed methodology study, combining retrospective and prospective data collection for 12 months pre-omalizumab and post-omalizumab initiation, respectively. SETTING: Data were collected in 22 UK NHS centres, including specialist centres and district general hospitals in the UK...
2016: BMJ Open
https://www.readbyqxmd.com/read/27489790/feasibility-of-a-smartphone-application-based-action-plan-and-monitoring-in-asthma
#15
Mi-Yeong Kim, Suh-Young Lee, Eun-Jung Jo, Seung-Eun Lee, Min-Gyu Kang, Woo-Jung Song, Sae-Hoon Kim, Sang-Heon Cho, Kyung-Up Min, Ki-Hwan Ahn, Yoon-Seok Chang
BACKGROUND: Asthma patients may experience acute episodic exacerbation. The guidelines recommend that written action plan should be given to asthma patients. However, no one can predict when and where acute exacerbation will happen. As people carry smart phone almost anytime and anywhere, smartphone application could be a useful tool in asthma care. We evaluated the feasibility of the ubiquitous healthcare system of asthma care using a smartphone application (snuCare) based on the self-management guideline or action plan...
July 2016: Asia Pacific Allergy
https://www.readbyqxmd.com/read/27440625/implementation-of-an-emergency-department-based-clinical-pharmacist-transitions-of-care-program
#16
Elizabeth Hohner, Melinda Ortmann, Umbreen Murtaza, Sheeva Chopra, Patricia A Ross, Meghan Swarthout, Leigh Efird, Emily Pherson, Mustapha Saheed
PURPOSE: The implementation of an emergency department (ED)-based clinical pharmacist transitions-of-care (TOC) program is described. SUMMARY: The intervention program consisted of collaboration between ED and ambulatory care pharmacists to provide patient-specific comprehensive medication review and education in the ED setting and to help ensure a coordinated transition to the ambulatory care setting by scheduling an ambulatory pharmacy clinic or home-based visit...
August 1, 2016: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/27438353/association-between-levels-of-fractional-exhaled-nitric-oxide-and-asthma-exacerbations-in-thai-children
#17
Nualanong Visitsunthorn, Nawinda Mahawichit, Kittipong Maneechotesuwan
BACKGROUND AND OBJECTIVE: Fractional exhaled nitric oxide (FeNO) has been used as a marker for airway inflammation. We evaluated the association between FeNO levels and asthma exacerbations (AEs) in Thai children and young adults. METHODS: This was a prospective cohort study in patients with atopic asthma aged 7-20 years. Asthma control level and management were evaluated every 3 months for 1 year. Spirometry and FeNO measurements were performed at baseline, and 6 and 12 months...
July 20, 2016: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/27353685/the-intersection-between-asthma-and-acute-chest-syndrome-in-children-with-sickle-cell-anaemia
#18
REVIEW
Michael R DeBaun, Robert C Strunk
Acute chest syndrome is a frequent cause of acute lung disease in children with sickle-cell disease. Asthma is common in children with sickle-cell disease and is associated with increased incidence of vaso-occlusive pain events, acute chest syndrome episodes, and earlier death. Risk factors for asthma exacerbation and an acute chest syndrome episode are similar, and both can present with shortness of breath, chest pain, cough, and wheezing. Despite overlapping risk factors and symptoms, an acute exacerbation of asthma or an episode of acute chest syndrome are two distinct entities that need disease-specific management strategies...
June 18, 2016: Lancet
https://www.readbyqxmd.com/read/27333779/the-perception-of-asthma-severity-in-children
#19
REVIEW
Lindsay Still, William K Dolen
The ability to perceive the onset and severity of symptoms of worsening asthma is important, not only for initial diagnosis but also for early identification of an asthma exacerbation and prompt management. There are subjective and objective methods for identifying symptoms. Symptom perception is affected by multiple mechanisms, and not all patients can accurately perceive symptoms of airflow limitation. Hyperperceivers will report substantial discomfort in the face of minimal bronchoconstriction, and poor perceivers will report no symptoms even in the presence of severe obstruction...
July 2016: Current Allergy and Asthma Reports
https://www.readbyqxmd.com/read/27330031/physiological-and-biological-predictors-of-length-of-stay-and-recovery-in-adults-with-acute-asthma-an-observational-cohort-study
#20
Thomas L Jones, Jonathon Owen, Scott Elliott, Thomas Brown, Dominic Reynish, Heena Mistry, Sumita Kerley, Salah Matti, Janis K Shute, Anoop J Chauhan
INTRODUCTION: Asthma is a prevalent, chronic disease associated with significant risk to patients and cost to healthcare systems. Accurate estimates of length of stay and recovery are important for patient information, physician prognostication, and management of inpatient beds. OBJECTIVES: To assess factors affecting length of stay and time to recovery in adults with acute asthma. METHODS: We prospectively recruited adult asthmatic non-smokers admitted with an asthma exacerbation...
June 22, 2016: Clinical Respiratory Journal
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