The Journal of asthma : official journal of the Association for the Care of Asthma
-
Randomized Controlled Trial
Cost benefits of a peer-led asthma self-management program for adolescents.
Frequent use of health-care services associated with pediatric asthma places substantial economic burden on families and society. The purpose of this study is to examine the cost-saving effects of a peer-led program through reduction in health-care utilization in comparison to an adult-led program. ⋯ An asthma self-management program using peer leaders can potentially yield health-care cost savings through the reduction in acute office visits in comparison to a traditional program led by health-care professionals.
-
Obstructive sleep apnea (OSA) worsens nocturnal asthma, but its potential impact on daytime asthma remains largely unassessed. We investigated whether the sleep disorder is associated with daytime, in addition to nighttime, asthma symptoms. ⋯ Questionnaire-defined OSA risk and historical diagnosis were each associated with persistent daytime asthma symptoms, to an extent that matched or exceeded associations with nighttime asthma symptoms. Unrecognized OSA may be a reason for persistent asthma symptoms during the day as well as the night.
-
Randomized Controlled Trial Multicenter Study
The efficacy and tolerability of intravenous montelukast in acute asthma exacerbations in Japanese patients.
In Japan, the Asthma Prevention and Management Guidelines recommend nebulized β-agonists, IV (intravenous) drip corticosteroids, as well as IV drip aminophylline for acute asthma treatment. However, current treatment for acute asthma provides inadequate benefit for some patients. We evaluated the efficacy and safety of IV montelukast added to standard therapy in Japanese patients with acute asthma exacerbations. ⋯ IV montelukast was significantly more effective than placebo in the improvement of ΔFEV(1) in Japanese patients, suggesting its role as an adjunctive therapy to existing guideline recommendations.
-
Randomized Controlled Trial
Effectiveness of educational interventions on asthma self-management in Punjabi and Chinese asthma patients: a randomized controlled trial.
Asthma tends to be less well controlled among ethnic minority groups, and its prevalence in new immigrants increases significantly the longer they are in Canada; mainly due to their lack of familiarity with English and difficulty understanding information regarding the disease, health literacy, cultural issues, housing conditions, and lack of access to appropriate care services. ⋯ Participants performed significantly better at follow-up than they did at baseline assessment, with the most notable improvements observed in the group that watched both community and knowledge videos. The results suggest that short, simple, culturally, and linguistically appropriate interventions can promote knowledge gain about asthma and improve inhaler use that can be sustained over the short term. Such interventions that provide authentic learning materials that draw on patients' life experiences and sociocultural context can overcome certain limitations of conventional patient education approaches.
-
Case Reports
Bronchial thermoplasty: therapeutic success in severe asthma associated with persistent airflow obstruction.
Severe persistent asthma is a disabling condition associated with significant morbidity and rising mortality worldwide. The recent advent of bronchial thermoplasty (BT) has offered a revolutionary therapeutic option for the treatment of severe persistent asthma. This minimally invasive bronchoscopic procedure focuses on anatomical manipulation of bronchial smooth muscle to attenuate airway hyperresponsiveness. ⋯ This case represents BT success and a change to the traditional paradigm governing the treatment of refractory asthma.