Asthma Watch

Published Online: Wednesday, August 1, 2007
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Pharmacy Program Helps with Asthma Care
Researchers in Australia have found that pharmacists can help asthma patients control their condition better through a pharmacy-based program. The program involved patients meeting with their pharmacists at least twice in a 6-month period for instruction on how to better adhere to their medication regimens and prevent wheezing and breathlessness attacks. Out of 191 patients who took part in the program, the percentage with severe asthma (>1 attack per week) fell from 87.9% to 52.7%. The findings were reported in the June 2007 issue of Thorax.

Fifty pharmacies in Australia were randomized into 2 groups: one group administered the Pharmacy Asthma Care Program to 191 patients; the other group gave their usual care to 205 control patients. The researchers found that the control group that did not take part in the program showed virtually no change in severe asthma attacks. Lead study author Carol Armour, PhD, of the University of Sydney, said that the findings suggested that similar pharmacy programs should be developed and tested. ?By spending structured and targeted time in the pharmacy, the health and well-being of people with asthma is significantly improved,? she said.

Asthma Still Uncontrolled in Many Patients
Even though most patients had health insurance and made regular visits to health care providers, a recent survey showed that 55% of US moderate-to-severe asthma patients still did not have proper control over their condition. The researchers also found that 38% of asthma patients who did have control and 54% of those who did not ?reported having had an attack during which they feared for their life.?

Researchers at the Wake Forest University School of Medicine?s Center for Human Genomics conducted a survey of 1812 asthma patients who had a diagnosis of asthma for =1 year and had been on a prescribed standard therapy for symptom control. The researchers found that only 26% of controlled patients and 35% of uncontrolled patients had received personalized asthma action plans from their physicians, which have been found to be related to fewer hospitalizations, as well as improved lung function.

Several comorbidities were predictive of uncontrolled asthma, including gastroesophageal reflux disease, chronic sinusitis, or high blood pressure. Younger age, lower income, Hispanic heritage, and male gender also were indicative of uncontrolled asthma. (The findings were published in the June 2007 issue of the Journal of Allergy and Clinical Immunology.)

Technique Can Help Improve Breathing and Mood
A breathing technique that was introduced almost 40 years ago can help today?s asthma patients reduce their symptoms and improve their mood. In the 1960s, a sequence of breathing and relaxation exercises that came to be known as the Papworth method was developed at Papworth Hospital in Cambridgeshire, United Kingdom. The method teaches patients how to manage the stress response, relax, and integrate breathing techniques into their regular routines. Despite its long history of use, however, no randomized trials had examined the method?s efficacy.

Researchers from University College London assessed the outcomes of 85 asthma patients who randomly received either their usual asthma care or 5 sessions of the Papworth method. Their respiratory symptoms and mood were evaluated at the study start and again at 6 and 12 months. The patients who learned the method experienced significantly greater improvement in respiratory symptoms and reductions in anxiety, depression, and dysfunctional breathing, compared with those who did not use the method. (The results of the study appeared in the June 2007 issue of Thorax.)

Sniffing Out Asthma with the Enose
A device usually used to sniff out bombs and improve roast coffee might have a future as a detector of asthma. Researchers at the Leiden University Medical Center in Holland have found that the electronic nose?or ?Enose??may be able to spot differences in the breath of individuals with or without asthma, thus aiding in more accurate diagnosis of the illness. The findings were presented in May 2007 at the American Thoracic Society International Conference in San Francisco, Calif.

At present, asthma is diagnosed based on symptoms and measure of lung function. Signs include coughing, shortness of breath, wheezing, and feeling of tightness in the chest. The problem is that other conditions can also exhibit these symptoms, such as bronchitis, sinusitis, and overexposure to secondhand smoke. The Enose sniffs out asthma through chemical vapor sensors that detect volatile organic compounds in exhaled breath.

The researchers found that their Enose was able to distinguish patients with mild and severe asthma from those who did not have asthma, although it had more difficulty determining individual asthma severity. If the findings are validated by future studies, the researchers hope that ?Enose technology might be a noninvasive, quick, cheap, and easy-to-perform [diagnostic] method.?



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