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Monday, October 1, 2012
  Clinical Accuracy Spoken Here  

Asthma Treatment:
Consider Allergen Exposure

Airway allergic reaction caused by natural exposure to allergens can lead to increased  inflammatory reaction, increased airway hyper-responsiveness and increased eosinophils in bronchoalveolar lavage. Research has demonstrated that asthma symptoms, pulmonary function, and need for medication in mite-sensitive patients correlate with the level of house-dust mite exposure. Reducing house-dust mite exposure reduces asthma symptoms, nonspecific bronchial hyper-responsiveness, and active inflammation. Inhalant allergen exposure to seasonal outdoor fungal spores and to indoor allergens has also been implicated in fatal exacerbations. Allergen exposure must be considered in the treatment of asthma.

[Reference: Asthma, Module A, Pathophysiology]

  Excellence in Case Mgmt  

Asthma: Tips for More Effective Communication with Patients

  • Limit the amount of information given at any one time
  • Categorize information into three to five topics and tell patients these categories before discussing the topics
  • Use terms that are familiar to the patient, not medical jargon.
  • Be concrete and specific.
  • Provide simple, easy-to-read directions for asthma management activities that require multiple steps.
  • Ask patients how they will remind themselves to take the recommended action
  • Repeat key points.
  • Rehearsal and reinforcement are important.

[Reference: Asthma, Module D, CM Role]

  Improving Patient Care...  

Asthma: Steroid Resistance

A small sub-population of asthma patients display persistent immune activation and airway inflammation despite high doses of inhaled corticosteroids. These patients have been classified as "steroid resistant". A complete and comprehensive evaluation of the patient needs to be conducted to ensure that the diagnosis is correct and that confounding factors have been eliminated. A major contributor to steroid resistance appears to be continuous airway inflammation. Airway structural changes (remodeling) may predispose the patient to residual symptoms and the development of irreversible airway disease. Also, some patients could be experiencing non-inflammatory airway hyper-responsiveness.

[Reference: Asthma, Module C, Pharmacologics]


Tom RasmussenTom Rasmussen
Athena Forum


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