Systematic Assessment of Difficult-to-Treat Asthma: Principles and Perspectives
Publikation: Bidrag til tidsskrift › Review › Forskning › fagfællebedømt
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Systematic Assessment of Difficult-to-Treat Asthma : Principles and Perspectives. / Hew, Mark; Menzies-Gow, Andrew; Hull, James H.; Fleming, Louise; Porsbjerg, Celeste; Brinke, Anneke Ten; Allen, David; Gore, Robin; Tay, Tunn Ren.
I: The Journal of Allergy and Clinical Immunology: In Practice, Bind 8, Nr. 7, 2020, s. 2222-2233.Publikation: Bidrag til tidsskrift › Review › Forskning › fagfællebedømt
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TY - JOUR
T1 - Systematic Assessment of Difficult-to-Treat Asthma
T2 - Principles and Perspectives
AU - Hew, Mark
AU - Menzies-Gow, Andrew
AU - Hull, James H.
AU - Fleming, Louise
AU - Porsbjerg, Celeste
AU - Brinke, Anneke Ten
AU - Allen, David
AU - Gore, Robin
AU - Tay, Tunn Ren
PY - 2020
Y1 - 2020
N2 - Difficult-to-treat asthma affects a minority of adults and children with asthma but represents a challenging mix of misdiagnosis, multimorbidity, inadequate self-management, severe airway pathobiology, and treatment complications. Management of these patients extends beyond asthma pharmacotherapy, because multiple other patient-related domains need to be addressed as well. Such complexity can hinder adequate clinical assessment even when performed in specialist practice. Systematic assessment undertaken by specialized multidisciplinary teams brings a broad range of resources to bear on patients with difficult-to-treat asthma. Although the concept of systematic assessment is not new, practices vary considerably and implementation is not universal. Nevertheless, assessment protocols are already in place in several institutions worldwide, and outcomes after such assessments have been highly encouraging. This review discusses the rationale, components, and benefits of systematic assessment, outlining its clinical utility and the available evidence for improved outcomes. It describes a range of service configurations and assessment approaches, drawing examples from severe asthma centers around the world to highlight common essential elements. It also provides a framework for establishing such services and discusses practical considerations for implementation.
AB - Difficult-to-treat asthma affects a minority of adults and children with asthma but represents a challenging mix of misdiagnosis, multimorbidity, inadequate self-management, severe airway pathobiology, and treatment complications. Management of these patients extends beyond asthma pharmacotherapy, because multiple other patient-related domains need to be addressed as well. Such complexity can hinder adequate clinical assessment even when performed in specialist practice. Systematic assessment undertaken by specialized multidisciplinary teams brings a broad range of resources to bear on patients with difficult-to-treat asthma. Although the concept of systematic assessment is not new, practices vary considerably and implementation is not universal. Nevertheless, assessment protocols are already in place in several institutions worldwide, and outcomes after such assessments have been highly encouraging. This review discusses the rationale, components, and benefits of systematic assessment, outlining its clinical utility and the available evidence for improved outcomes. It describes a range of service configurations and assessment approaches, drawing examples from severe asthma centers around the world to highlight common essential elements. It also provides a framework for establishing such services and discusses practical considerations for implementation.
KW - Adherence
KW - Comorbidities
KW - Diagnosis
KW - Difficult asthma
KW - Personalized medicine
KW - Protocolized
KW - Severe asthma
KW - Treatable traits
U2 - 10.1016/j.jaip.2020.02.036
DO - 10.1016/j.jaip.2020.02.036
M3 - Review
C2 - 32173508
AN - SCOPUS:85082523545
VL - 8
SP - 2222
EP - 2233
JO - The Journal of Allergy and Clinical Immunology: In Practice
JF - The Journal of Allergy and Clinical Immunology: In Practice
SN - 2213-2198
IS - 7
ER -
ID: 250386605