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This articel summarises the evidence base underpinning supported self-management for asthma. It provides clinicians with a practical approach to providing supported self-management ... asthma and suggests an appropriate strategy for implementing supported self-management. more
Asthma prevalence is increasing worldwide and surveys indicate that the majority of patients in developed and developing countries do not receive optimal care and are therefore not well controlled. The aim of these guidelines is to promote a better ... more
Asthma is the commonest chronic childhood disease and encompasses a spectrum of airway diseases with similar symptoms. Inaccurate diagnosis remains common, especially in younger children, with failure to characterize the different “...s.” Children worldwide repeatedly suffer symptoms which severely affect their everyday lives. Children die from asthma, especially in low and middle-income countries (LMICs). In many countries, asthma prevalence is rising. Access to effective care and changing environments are hugely variable and may explain the higher morbidity in inner-city children, in LMICs, and in deprived populations in high-income countries. Despite the disease being eminently controllable, morbidity and mortality persist. more
The document "Chronic Respiratory Diseases: A Handbook for Pharmacists" outlines the significant role pharmacists play in managing asthma and COPD, emphasizing patient education, disease prevention,... more
The European Respiratory Society (ERS)/American Thoracic Society (ATS) Task Force on severe asthma includes an updated definition of severe asthma, a discussion of severe ... phenotypes in relation to genetics, natural history, pathobiology and physiology, as well as sections on evaluation and treatment of severe asthma where specific recommendations for practice are made. See the unabridged online version of the document for detailed discussion of the definition of severe asthma, phenotypes and recommendations for practice. more
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Data on asthma aetiology in Africa are scarce. We investigated the risk factors for asthma among schoolchildren (5–17 years) in urban Uganda. We ... more
The Global Asthma Report (GAR) 2022, prepared by the Global Asthma Network (GAN), is the fourth ... more
The pharmacological management of asthma has changed considerably in recent decades, as it has come to be understood that it is a complex, heterogeneous disease with different phenotypes and endotypes. It is now clear that the goal of ... treatment should be to achieve and maintain control of the disease, as well as to minimize the risks (of exacerbations, disease instability, accelerated loss of lung function, and adverse treatment effects). That requires an approach that is personalized in terms of the pharmacological treatment, patient education, written action plan, training in correct inhaler use, and review of the inhaler technique at each office visit. A panel of 22 pulmonologists was invited to perform a critical review of recent evidence of pharmacological treatment of asthma and to prepare this set of recommendations, a treatment guide tailored to use in Brazil. The topics or questions related to the most significant changes in concepts, and consequently in the management of asthma in clinical practice, were chosen by a panel of experts. To formulate these recommendations, we asked each expert to perform a critical review of a topic or to respond to a question, on the basis of evidence in the literature. In a second phase, three experts discussed and structured all texts submitted by the others. That was followed by a third phase, in which all of the experts reviewed and discussed each recommendation. These recommendations, which are intended for physicians involved in the treatment of asthma, apply to asthma patients of all ages. more
Background Asthma education, a key component of long-term asthma management, is challenging in resource-limited settings with shortages of clinical staff. Task-shifting educational roles to lay (no... more
sthma prevalence is increasing worldwide, and surveys indicate that most patients in developed and developing countries, including South Africa, do not receive optimal care and are therefore not well controlled. Standard management guidelines adapted to in-country realities are important to support ... more
Under-diagnosis of asthma in ‘under-fives’ may be alleviated by improved inquiry into disease history. We assessed a questionnaire-based screening tool for ... among 614 ‘under-fives’ with severe respiratory illness in Uganda. The questionnaire responses were compared to post hoc consensus diagnoses by three pediatricians who were guided by study definitions that were based on medical history, physical examination findings, laboratory and radiological tests, and response to bronchodilators. Children with asthma or bronchiolitis were categorized as “asthma syndrome”. Using this approach, 253 (41.2%) had asthma syndrome. History of and present breathing difficulties and present cough and wheezing was the best performing combination of four questionnaire items [sensitivity 80.8% (95% CI 77.6–84.0); specificity 84.7% (95% CI 81.8–87.6)]. The screening tool for asthma syndrome in ‘under-fives’ may provide a simple, cheap and quick method of identifying children with possible asthma. The validity and reliability of this tool in primary care settings should be tested. more
The Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013-2020 by the World Health Organization (WHO) outlines a comprehensive strategy to address the ... rise in noncommunicable diseases (NCDs), including cardiovascular diseases, cancer, chronic respiratory diseases, and diabetes. more
An estimated 1.3 billion people – or 16% of global population worldwide – experience a significant disability today. Persons with disabilities have the right to the highest attainable standard of health as those without disabilities. However, th... more
The standards define 10 key competencies for health and care workers to support self-care in their clinical practice as well as the specific, measurable behaviours that demonstrate those competencies, focusing on people-centredness; decision-making;... more
This report reviews the current situation in relation to national capacity to address NCDs and the progress made at country level over the past decade. It highlights that, while progress is being made, there is still much work to be done to create the infrastructure, policies, surveillance and healt... more
History has shown that governments tend to deprioritize environmental commitments during times of financial and public crises as they work to mitigate immediate needs—and the age of COVID-19 has been no different. Even though human interaction with wildlife is believed to be the cause of the pande... more