How many people have uncontrolled asthma

The researchers write that several factors contribute to the high cost of uncontrolled asthma and the staggering loss of quality of life. Barriers to implementing evidence-based practices and the need for more effective medicines for people with severe or exacerbation-prone asthma contribute to uncontrolled asthma.

In conducting their study, the researchers analyzed data for the entire U. The direct costs of uncontrolled asthma estimated in the study are for health care services over and beyond what patients with controlled asthma use.

It can have different triggers, attack in different forms, and may sometimes require specialized treatment. May is Asthma and Allergy Awareness Month, a peak season for the millions of Americans living with asthma and allergies. Here are the six most important questions you need to know about severe, uncontrolled asthma.

Asthma is an inflammatory disease that causes the airways in the lungs to become swollen or inflamed and over-reactive to triggers like pollen, dust, or smoke. Severe asthma requires medium- to high-dose inhaled corticosteroids plus another asthma controller medication and may require the addition of oral corticosteroids. However, despite using high-dose medicines, reducing risks, and following a treatment plan, many times asthma remains uncontrolled 1.

According to the American Lung Association, people with uncontrolled asthma experience at least three of the following 2 :. Asthma control reflects the level of minimizing the frequency and intensity of symptoms and functional limitations. On average, The level of asthma control varied by state, but did not follow a specific geographic pattern. Percentages of children with current asthma who had uncontrolled asthma ranged from The aim of asthma management is to control the disease.

Complete control of asthma is defined as:. Before initiating a new drug in patients who have uncontrolled asthma, it is important their adherence with existing therapies is confirmed, inhaler technique is checked and any trigger factors eliminated see Assessment.

In children, a pMDI and spacer is the preferred method of delivering a SABA and ICS, as young children may be unable to produce the inspiratory effort required to use higher resistance dry powder inhalers. LABA monotherapy in asthma has been associated with an increase in asthma deaths, but this is not seen when used in combination with an ICS.

Where asthma remains uncontrolled despite low dose ICS with LABA, it is essential to confirm the diagnosis and to check adherence and inhaler technique before stepping up treatment. Table 2 provides more information on low, medium and high doses of combination inhalers. Continuous oral corticosteroids are rarely recommended, but may be required under specialist care in patients with confirmed asthma who remain uncontrolled despite adequate trials of high dose ICS and all other add-on therapies.

These patients require referral to a severe asthma centre for review, and may be eligible for monoclonal antibody treatment. Patients should be reviewed regularly and, once asthma control has been achieved, consideration should be made to step down treatment to use the lowest effective doses to avoid adverse effects.

Stepping down treatment is recommended every three weeks in patients whose asthma is stable. Which drug is reduced or stopped at each review depends on patient preference, response, adverse effects and severity of asthma. This suggests the majority of adults with asthma would be unlikely to achieve any significant clinical benefits from increasing ICS doses above medium doses.

It is important to note that the efficacy of ICS may be reduced by current or past smoking. This may be overcome by increasing the dose. In primary care, pharmacists should closely monitor severe asthmatics, particularly to ensure continued adherence to their preventative therapies.

Good communication between primary care, community pharmacists and the severe asthma service is essential to ensure patients remain on the correct therapies and that any changes in adherence or control increased SABA use or additional courses of oral steroids are highlighted early to the specialist centre. Any change in treatment should be advised by the specialist centre.