CHEST Guidelines-Improving-Asthma-Management

Improving-Asthma-Management_chest

Pdf Summary

The provided document from November 2012's issue of CHEST discusses asthma management and the concept of out-of-proportion pulmonary hypertension (PH). The document comprises mainly two summaries regarding research and positions on these medical topics.<br /><br />The first section addresses asthma management, emphasizing the critical role of asthma self-management education, which includes self-management training, regular clinician assessment, and a written action plan. Evidence suggests that these plans improve medication adherence and patient satisfaction but not necessarily better asthma control, according to a study by Patel et al., involving 808 women. Despite these benefits, provision of written asthma action plans in clinical practice remains limited.<br /><br />The second section explores out-of-proportion PH, first identified in diseases like advanced pulmonary Langerhans cell histiocytosis (PLCH) and associated with unusually severe PH relative to the extent of lung disease. This PH variant is often unexplained by typical factors like hypoxia and has been arbitrarily defined by a high mean pulmonary artery pressure. Recent analysis by Le Pavec et al. highlights its prevalence in PLCH and the potential efficacy of medications used in idiopathic pulmonary arterial hypertension (iPAH) for treatment. This document also compares out-of-proportion PH in other rare diseases such as lymphangioleiomyomatosis and idiopathic pulmonary fibrosis (IPF), often showing a similar divergence between observed PH and lung pathology severity.<br /><br />The document notes that while more definitive studies are required to prove the benefits of asthma action plans and to better understand PH related to rare diseases, current evidence supports their integration into medical practice for improved disease management. The document ends with a call for consistent adhesion to national guidelines and the potential role of technology in improving asthma action plan dissemination and use.

Keywords

asthma management

self-management education

pulmonary hypertension

written action plan

medication adherence

pulmonary Langerhans cell histiocytosis

idiopathic pulmonary arterial hypertension

lung disease

national guidelines

technology in healthcare