The Asthma Controller Step-down Yardstick.


Journal

Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology
ISSN: 1534-4436
Titre abrégé: Ann Allergy Asthma Immunol
Pays: United States
ID NLM: 9503580

Informations de publication

Date de publication:
03 2019
Historique:
received: 25 10 2018
revised: 02 12 2018
accepted: 03 12 2018
pubmed: 15 12 2018
medline: 25 12 2019
entrez: 15 12 2018
Statut: ppublish

Résumé

Asthma guidelines recommend a control-based approach to disease management in which the assessment of impairment and risk is linked to step-based therapy. Using this model, controller treatment is adjusted-upward or downward-according to a patient's level of asthma control over time. Strategies for stepping up controller therapy are well described, and the adult and pediatric Asthma Yardsticks provide operational recommendations based on patient profiles. Strategies for stepping down controller treatment are less clear, although stepping down to the minimum effective therapy is important and should be considered when a patient's asthma has been well controlled for an adequate period as defined by risk and impairment. This Yardstick presents recommendations for when and how to step down asthma controller therapy according to guideline-defined control levels. The objective is to provide clinicians who treat patients with asthma with a practical and clinically relevant framework for implementing a step-down in controller therapy.

Identifiants

pubmed: 30550809
pii: S1081-1206(18)31504-7
doi: 10.1016/j.anai.2018.12.004
pii:
doi:

Substances chimiques

Adrenal Cortex Hormones 0
Adrenergic beta-Agonists 0
Anti-Asthmatic Agents 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

241-262.e4

Informations de copyright

Copyright © 2018. Published by Elsevier Inc.

Auteurs

Bradley E Chipps (BE)

Capital Allergy & Respiratory Disease Center, Sacramento, California. Electronic address: bchipps@capitalallergy.com.

Leonard B Bacharier (LB)

Washington University School of Medicine and St. Louis Children's Hospital, Division of Allergy, Immunology and Pulmonary Medicine, Saint Louis, Missouri.

Kevin R Murphy (KR)

Boys Town National Research Hospital, Boys Town, Nebraska.

David Lang (D)

Division of Allergy and Clinical Immunology, Cleveland Clinic Foundation, Cleveland, Ohio.

Judith R Farrar (JR)

Academic Services Connection, Inc., Pittsford, New York.

Matthew Rank (M)

Division of Allergy, Asthma, and Clinical Immunology, Mayo Clinic, Scottsdale, Arizona.

John Oppenheimer (J)

Rutgers Medical School, Newark, New Jersey.

Robert S Zeiger (RS)

Kaiser Permanente Southern California Region, Department of Allergy and Research and Evaluation, San Diego and Pasadena, California.

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Classifications MeSH