Ww. Busse et al., TREATMENT REGIMEN AND SIDE-EFFECTS OF TREATMENT MEASURES, American journal of respiratory and critical care medicine, 149(2), 1994, pp. 190000044-190000050
Citations number
9
Categorie Soggetti
Emergency Medicine & Critical Care","Respiratory System
The severity of asthma can be judged by many features, including the n
eed for medication and associated side effects. Since asthma has both
acute and chronic characteristics, therapeutic regimens should be valu
able as an instrument to define disease severity and the consequence o
f intervention. However, because of the variability of asthma severity
within each patient, medication quantitation as an index of asthma se
verity is not without difficulty and limitation. Furthermore, the phil
osophy of asthma therapy has undergone changes over the past decade. P
reviously, anti-inflammatory therapy was reserved for only the most se
verely ill patients. Now, inflammation is recognized as a critical com
ponent of asthma, and all patients with active asthma (other than mild
symptoms) are recommended to use anti-inflammatory therapy. Although
there is little published experience with treatment regimens as an ind
ex of disease severity, those that have been used have found validity
and reproducibility with this approach. In this paper, a scoring appro
ach to medication use is recommended. Medication is classified into br
onchodilator (P-agonists, theophylline, and anticholinergic) or anti-i
nflammatory (corticosteroid and cromolyn sodium). Medication scores ar
e given on either a per-use or a new-dosage basis. Furthermore, the ei
ght medications are stratified according to potency (i.e., inhaled cor
ticosteroid < oral corticosteroid < parenteral corticosteroid). From t
his approach, the severity of an individual patient's asthma can be qu
antitated, and this value can serve as one instrument to assess diseas
e severity.