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Assessing the risk of attack in the management of asthma: a review and proposal for revision of the current control-centred paradigm

Assessing the risk of attack in the management of asthma: a review and proposal for revision of the current control-centred paradigm
Assessing the risk of attack in the management of asthma: a review and proposal for revision of the current control-centred paradigm
Asthma guidelines focus on day-to-day control of symptoms. However, asthma attacks remain common. They continue to cause mortality and considerable morbidity, and are a major financial burden to the UK National Health Service (NHS) and the wider community. Asthma attacks have chronic consequences, being associated with loss of lung function and significant psychological morbidity. In this article we argue that addressing daily symptom control is only one aspect of asthma treatment, and that there should be a more explicit focus on reducing the risk of asthma attacks. Management of future risk by general practitioners is already central to other conditions such as ischaemic heart disease and chronic renal impairment. We therefore propose a revised approach that separately considers the related domains of daily control and future risk of asthma attack. We believe this approach will have advantages over the current ‘stepwise’ approach to asthma management. It should encourage individualised treatment, including non-pharmacological measures, and thus may lead to more efficacious and less harmful management strategies. We speculate that this type of approach has the potential to reduce morbidity and healthcare costs related to asthma attacks
1471-4418
344-352
Blakey, John D.
40ef8163-32fd-448e-8704-b02a9a83296c
Woolnough, Kerry
a2bc3728-1297-42f4-bc81-508c88c9af31
Fellows, Jodie
94f6abe3-1079-4ca0-861f-0f846fb2d64b
Walker, Samantha
efd94eef-c319-4d3b-be10-61cb2b7cb5e7
Thomas, Mike
997c78e0-3849-4ce8-b1bc-86ebbdee3953
Pavord, Ian D.
ee414b70-d199-4271-be4f-408da5bcad8f
Blakey, John D.
40ef8163-32fd-448e-8704-b02a9a83296c
Woolnough, Kerry
a2bc3728-1297-42f4-bc81-508c88c9af31
Fellows, Jodie
94f6abe3-1079-4ca0-861f-0f846fb2d64b
Walker, Samantha
efd94eef-c319-4d3b-be10-61cb2b7cb5e7
Thomas, Mike
997c78e0-3849-4ce8-b1bc-86ebbdee3953
Pavord, Ian D.
ee414b70-d199-4271-be4f-408da5bcad8f

Blakey, John D., Woolnough, Kerry, Fellows, Jodie, Walker, Samantha, Thomas, Mike and Pavord, Ian D. (2013) Assessing the risk of attack in the management of asthma: a review and proposal for revision of the current control-centred paradigm. Primary Care Respiratory Journal, 22 (3), 344-352. (doi:10.4104/pcrj.2013.00063). (PMID:23817678)

Record type: Article

Abstract

Asthma guidelines focus on day-to-day control of symptoms. However, asthma attacks remain common. They continue to cause mortality and considerable morbidity, and are a major financial burden to the UK National Health Service (NHS) and the wider community. Asthma attacks have chronic consequences, being associated with loss of lung function and significant psychological morbidity. In this article we argue that addressing daily symptom control is only one aspect of asthma treatment, and that there should be a more explicit focus on reducing the risk of asthma attacks. Management of future risk by general practitioners is already central to other conditions such as ischaemic heart disease and chronic renal impairment. We therefore propose a revised approach that separately considers the related domains of daily control and future risk of asthma attack. We believe this approach will have advantages over the current ‘stepwise’ approach to asthma management. It should encourage individualised treatment, including non-pharmacological measures, and thus may lead to more efficacious and less harmful management strategies. We speculate that this type of approach has the potential to reduce morbidity and healthcare costs related to asthma attacks

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More information

Accepted/In Press date: 13 April 2013
e-pub ahead of print date: 2 July 2013
Published date: September 2013
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 354257
URI: https://eprints.soton.ac.uk/id/eprint/354257
ISSN: 1471-4418
PURE UUID: cd39eb09-9170-4ec6-bf2b-09cea87ef10b

Catalogue record

Date deposited: 05 Jul 2013 07:57
Last modified: 16 Jul 2019 21:29

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