Hello and welcome to overcoming challenges to
successful asthma adherence and control.
So, today, we’re going to be talking
about the prevalence of asthma,
its diagnosis and a lot about its management.
I have a lot to get through
and hope you really enjoy it.
So, this is current asthma prevalence
as measured by the US Centers for Disease Control and Prevention.
You can see that asthma is very common overall,
slightly more common among children versus adults,
slightly more common among females versus males,
and definitely more common among black
individuals compared with whites and Hispanics.
And so, we’ll talk about
best asthma practices today.
First of all, you want to get the right
classification for asthma initially.
It’s critical for starting the right kind treatment.
We’ll be talking about hazard reduction.
So, the basics of asthma management
because that can go a long way.
It's not all about medications alone.
Using the medications correctly is important
and we’ll be talking about the fact that
many individuals don't know how to use
their inhalers appropriately.
Then we’ll spend a lot of time on therapeutics
and talk about following up patients.
So, let’s talk about getting asthma right.
So, first, we think about getting the classification correct.
And this is something that could well
come up on the USMLE exam.
Intermittent asthma is defined by
symptoms less than two days per week.
The next class is mild persistent asthma.
Symptoms aren’t daily in these patients
and they relatively rare nighttime awakenings
with preserved FEV1 to FVC ratio.
Moderate persistent is associated with daily symptoms
as well as awakening at least on a weekly basis
and moderate impairment of that FEV1 to FVC ratio.
Severe persistent asthma is defined
by symptoms throughout the day,
limited function overall,
and a significantly reduced FEV1 overall.
Now, I think that this is important to consider
for the initial diagnosis of asthma,
but asthma does follow a variable course.
Can get better, can get worse.
Oftentimes, in children, over time, it does
tend to improve, but that can take years.
And so, once you make the initial diagnosis,
the key is follow them up closely and,
therefore – and until they’re well-controlled.
And if they have more symptoms,
they should come back to you
because these categories can change over time.
Just because you have mild persistent asthma
when you're 12 years old doesn't mean
you’re going to have it when you're 16.