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multidisciplinary approach to avoid out of control

The way the patient is treated determines the control of the pathology, his quality of life and reduces mortality: a new committee of specialists approaches in a multidisciplinary way severe asthma

Severe asthma: multidisciplinary approach to avoid uncontrolled


Mother and daughter show the inhalation devices for asthma medicine/EFE/IVAN MEJIA

92 specialists publish a consensus on the multidisciplinary and sequential approach to patients with severe asthma in Spain, a pathology that affects up to 10% of asthmatics and that in 50% of the cases is out of control.

Disease prevalence

And it is that in the world, even if the prevalence varies, severe asthma has an unquestionable presence.

  • A western europe up to 18% of asthma patients suffer from it.
  • A United States it can reach 19%.
  • A central europe to more than 30%.
  • Speaking of Spainbetween 5 and 10% of the population suffer from asthma, of which 10% have it aggravated.

Faced with these figures, the multidisciplinary approach becomes a necessity.

Addressing the pathology is a necessity

Faced with this reality, specialist pulmonologists from the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) have updated a new consensus documentin which a coordinating committee of 4 specialists participated, a recommendation drafting group with 11 experts, and finally, a recommendation validation group of 78 specialists.

The goal of this document, is:

  • Improve the treatment of these patients and his life quality.
  • Decrease the mortality rate.
  • Reduce the healthcare expenses that patients with severe asthma generate.

According to Dr. Francisco Javier Álvarez-Gutiérrez, coordinator of the document, as well as a pulmonologist and member of SEPAR, the multidisciplinary approach is necessary for several reasons.

“Not only is it essential to carry out complementary tests, which help us to confirm the diagnosis, but it is also necessary to analyze the factors that can contribute to the poor control of these patients, such as the misuse of inhalers or certain environmental factors”, indicates the specialist.

In addition to this observation, he adds a crucial factor: the identification of the phenotypes or subtypes of the diseasewhich can vary over time, making treatment difficult.

News of the proposal

This consensus involves a series of novelties compared to the previous version, among which stand out:

  • redefinition of the term “severe uncontrolled asthma“.
  • ladder to value the response to treatment i patient satisfaction.
  • The function of the is highlighted specialized nursing.
    • A fundamental task for the fulfillment of the home self-administration.

In addition, Álvarez-Gutiérrez talks about a more personalized medicine thanks to the advances:

  • Evolution and imaging techniques.
  • New ways to measure biological processes.
  • big data
  • Innovation of inhaled therapy devices: there are already inhalers that communicate with a smartphone app, allowing more comprehensive control of treatment monitoring from the patient.

Specialization in the subject

Another one of the outstanding recommendations of this consensus is the creation of units specialized in the treatment of this pathology.

the doctor Marina Blanco, pulmonologist and member of SEPARexplains that severe asthma requires the creation of specialized asthma units equipped with means and expert health personnel is a very reasonable option that would improve the health of patients.

In this sense, one of the pillars of these units are the nursing staffthose whose premise is to promote patients’ autonomy, their greater self-management and their empowerment, through individualized, progressive, dynamic and continuous treatments.

The object of these recommendations, points out Dr. Blanco, is none other than to prevent severe asthma from becoming a pathology defined by out of control.

“All these recommendations seek to control the disease, prevent exacerbations and airflow obstruction, reduce mortality and the side effects of the medication,” says the expert.

If specialists follow the recommendations, patients will live longer and better.

To prevent exacerbations and uncontrolled severe asthma…

SEPAR also does not neglect the role of patients in this way. To avoid any type of complication and/or loss of control with regard to severe asthma, they facilitate the following guidelines:

pollution and health
Pollution plays a crucial role in the pathology of asthma. EFE/Juanjo Martín
  1. Avoid the active and passive smokingalso of electronic cigarettes.
  2. Reduce the environmental pollution and the factors that condition the climate change.
  3. Check and remove, if applicable, the use of non-steroidal anti-inflammatory drugs and other drugswhich could cause exacerbations of the pathology.
  4. Avoid, if possible in allergic patients, those allergens which cause an increase in symptoms such as animal epithelium, moisture, mold, certain foods and other inhaled irritants.
  5. favor the vaccination anti-influenza, anti-pneumococcal and against COVID-19.
  6. strict compliance with asthma control treatment: the use of inhaled drugs, compliance with doses, their correct administration and all the recommendations included in the clinical reports of the specialists.
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