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Considerations in difficult‐to‐control asthma
Author(s) -
Lanier Bob Q.,
Tierce Millard
Publication year - 2015
Publication title -
international forum of allergy and rhinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.503
H-Index - 46
eISSN - 2042-6984
pISSN - 2042-6976
DOI - 10.1002/alr.21593
Subject(s) - medicine , asthma , comorbidity , intensive care medicine , population , throat , nose , medline , physical therapy , pediatrics , surgery , environmental health , political science , law
Background Difficult‐to‐control asthma includes those patients who require treatment with high‐dose inhaled glucocorticosteroid (ICS) plus a second controller and/or systemic glucocorticosteroids to manage. The exact percentage of “difficult to treat,” “refractory,” “severe,” or “brittle” asthma is 3% to 10% of all asthmatic patients, but this group of asthmatics use the majority of resources for the entire asthmatic population. Methods Medline searches for the terms “difficult to control,” “severe,” “refractory,” “brittle,” and asthma were done and the results were reviewed. Results Patterns for difficult‐to‐control asthma emerge from concepts of compliance, comorbidity, and endotypes, which give the practitioner pathways for analyzing this subset of asthma patients. Conclusion The ear, nose, and throat (ENT) physician can be of significant help to other asthma specialists in the recognition of the difficult‐to‐control asthmatic, as well as providing specific specialized diagnostic skills and the reinforcement of adherence to medical regimens.