A closer look is needed with the treatment of severe asthma
Asthma affects both young and old. And while there are available treatments for this disorder, there is a growing number who don't benefit from these treatments. With the advances in genetic studies it is hoped better methods of treatment can be produced.
Asthma strikes at any age.
There has been an increase in the number of asthma patients worldwide. But 5-10% of the severe form of the disease accounts for a large proportion of the health costs (Holgate & Polosa, 2006). Late-onset disease is often missed as being seen as COPD-Chronic Obstructive Pulmonary Disease and mistreated.
Tobacco use is also a contributing factor for increasing asthma severity by resulting in resistance to use of corticosteroids. In most cases of asthma, there are multiple factors. And many risk factors contribute to the chronic nature of the disease; triggering a worsening of the disease. It can also be an indication with problems of the environment. Asthma can also lead to difficulties in treating some heart conditions. Beta-blockers often used in heart disease can result in an increase in asthma related difficulties.
In addition, another common medicine suggests for heart and circulatory problems are NSAIDS and aspirin. Both of these groups of medication cause a longer clotting time leading to concerns of excessive bleeding especially in women of childbearing age.
Other factors are also seen in severe asthma are obstructive sleep apnea and vocal cord dysfunction. And as expected, obesity, especially in women, increases the difficulty of control and reoccurrences of symptoms. Treatment and diagnosis of severe asthma is difficult and often leads to under-treatment or poor adherence to treatment prescribed (Busse, et al, 2000).
With the recent increase in childhood asthma, the number of adults with severe asthma is likely to also increase as the children age. Asthma is now under genetic studies and they have shown some evidence of asthma and genetic connection.
Allergies to environmental factors seen with skin testing to one or more indoor allergens are also commonly seen in asthma. Things like dust mites, roaches, and animal dandruff are commonly reported as substances triggering asthma attacks. Exercise out of doors with these environmental allergies can often be difficult without provoking an attack.
Total costs that were studied that included medical and prescription drug purchases. It was discovered that the cost of controller medication was greater with the severe patients. Another finding was that patients with severe asthma also suffered from gastroesophageal reflux disease more commonly known as GERD (Ivanova, et al. 2012).
More than 24 million people in the US alone have asthma and of them, 10% have the severe form of the disease (Bringham and Women's, 2018). With a less than expected response to inhaled steroids has long been associated with severe asthma. What triggers this severe asthma is still poorly understood and requires further study.
Asthma is a serious health problem around the world. While many scientific advances have improved the understanding of asthma, control and maintenance of it can sometimes be costly. Effective care needs to be adapted to the local environment of the patient. Asthma is a chroic inflammatory condition of the of the airways. This chronic inflammation leads to an over board response by the airways. These episodes cause widespread decrease in airflow that either reverses on its own or with treatment of a rescue inhaler.
There is reason to believe the global burden of asthma can be reduced through efforts of individuals, their healthcare providers, healthcare organizations and local/national governments.
Currently, available therapies do not adequately prevent exacerbations for all asthmatic patients. And with the increasing health care costs among these patients, clearly, more work is needed.
Bringham and Womans Hospital. (2018). A Deeper Look at Severe Asthma Yields NET Results. Science News https://www.sciencedaily.com/releases/2018/08/180803143128.htm
Busse, W.W., Schlegel, S.B., Wenzel, S.E. (2000). Pathophysiology of Severe Asthma. Journal of Allergy Clinical Immunology, 106 (6). 1033-1042. Elsevier Doi: 10.1067/mai.2000.111307
Holgate, S.T. & Polosa, R. (2006). The Mechanisms, Diagnosis, and Management of Severe Asthma in Adults. The Lancet, vol. 368 pp. 780-793. http://www.thelancet.com
Ivanova, J.I., Bergman, R. et al (2012). Effects of Asthma Exacerbations on Health Care Costs Among Asthmatic Patients with Moderate and Severe Persistent Asthma. American Academy of Allergy, Asthma, and Immunology, 129(5). Doi: 10.1016/j.jaci.2012.01.039