The Journal of asthma : official journal of the Association for the Care of Asthma
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Review Comparative Study
Clinical assessment of asthma symptom control: review of current assessment instruments.
Health care providers are increasingly shifting asthma management from treating acute attacks to achieving symptom control to return patients to full functioning and improve their quality of life. Assessment instruments have been developed that quantify asthma patients' symptom control and quality of life. Several instruments are described in this review in terms of domains, psychometric qualities, ease of use, and ability to accurately reflect patients' overall condition. Problems with applicability and feasibility have limited the use of currently available instruments mainly to research settings or sporadic use in selected practices, generally leaving clinicians without the potential benefits of such tools to aid their routine clinical management of patients.
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Over 20 million Americans are affected with asthma. Many will require some type of surgical procedure during which their asthma management should be optimized. ⋯ The use of corticosteroids has not been shown to adversely affect wound healing or increase the rate of infections postoperatively. Preoperative systemic corticosteroids may be used safely in the majority of patients to decrease asthma-related morbidity.
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New emphasis on pediatric drug development makes the availability of safe, easy-to-use dosage formulations imperative for clinical practice. Chewable tablets are a widely used pediatric dosage form; however, a literature review on the safety of this formulation has not been published. We have, therefore, determined the safety of chewable tablets in the pediatric age group based on the published literature. ⋯ Medical issues, including foreign-body injuries, related to the chewable-tablet formulation were extremely rare. The advantages of chewable tablets include palatability, stability, precise dosing, portability, and ease of delivery. It is concluded that the available literature suggests that chewable tablets provide a safe, well-tolerated alternative to traditional pediatric drug formulations and offer significant advantages in children 2 years of age and older.
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Asthma has been considered a rare disease in the elderly, but recent studies have shown that it is as common in the elderly as in the middle-aged population. Diagnosis of asthma is often overlooked in older patients, leading to undertreatment. ⋯ Treatment of asthma in the elderly should follow the same stepwise guidelines that are recommended for all age groups, though it will require more intense monitoring. An aggressive treatment approach to mild and moderate asthma in young people is the best hope of changing the future trends of asthma in the elderly.