EN(polished)-Andrew McIvor CHINA Asthma Management英文 医学资料.pptx

Asthma managementAndrew McIvor MD, MSc, FRCPProfessor of MedicineFirestone Institute for Respiratory HealthThe Goal of Asthma Management is:Overall Asthma ControlachievingreducingCurrent controlFuture riskdefined bydefined bySymptomsReliever useInstability/worseningExacerbationsActivityLung functionLoss of lung functionAdverse effects of medicationNAEPP. Expert Panel Report 3. 2007Taylor DR, et al. Eur Respir J 2008; 32:545–554Asthma ControlCharacteristicFrequency or ValueDaytime symptoms 4 days/weekNight-time symptoms1 night/weekPhysical activityNormalExacerbationsMild, infrequentAbsence from work or school due to asthmaNoneNeed for a fast-acting β2-agnonist4 doses/weekFEV1 or PEF90% personal bestPEF diurnal variation?10-15%***FEV1 = forced expiratory volume in 1s; PEF = peak expiratory flow.?Diurnal variation is calculated as the highest PEF minus the lowest divided by the highest PEF multiplied by 100 for morning and night (determined over a 2 week period).Perceived Asthma Control978873PatientsPhysiciansCAEsTRAC Study Demonstrated a Major Gap Between Perception and Actual Level of Asthma ControlDemonstrated ACTUAL level of controlControlled 47% n=418 Uncontrolled53% Uncontrolled53% n=474Asthma in Canada remains poorly controlledTRAC: The Reality of Asthma Control in Canada; CAE: Certified Asthma Educator Telephone interviews were conducted between April and August 2004 with adults 18 to 54 years of age who had been diagnosed with asthma more than 6 months prior to the survey, who did not have chronic obstructive pulmonary disease, and who had a smoking history of fewer than 20 pack years (n=893).Adapted from FitzGerald JM, et al. Can Respir J. 2006;13(5):253-259.Personal Practice Assessment (PPA) Program - ResultsNationwide survey of primary care physicians (n=354 ) and their patients with asthma (n=10,428 )Chapman et al. Eur Respir J. 2008Chapman et al. Eur Respir J. 2008Physician assessment of control in the Primary Practice Audit studyChapman et al. Eur Respi