title: Variability in asthma: symptom perception, care, and outcomes.
abstract: Asthma remains a global respiratory health concern. Substantial variations in asthma outcomes persist in Canada despite the dissemination of national management guidelines. Many factors and their interactions presumably contribute to variations in outcomes, including asthma prevalence, severity, symptom recognition, self-management behaviour, access to care, and management. This article reviews the physiology of symptom perception in asthma, specifically the role of dynamic lung hyperinflation (DH) on the perception of the intensity and quality of dyspnea in asthma, and the link between blunted perception and life-threatening asthma. Additionally, the magnitude and correlates of regional variation in emergency department visit rates and hospitalizations for asthma in Ontario are reviewed.
authors.affiliation: Asthma Research Unit, Clinical Research Centre, Kingston General Hospital, Division of Respirology, Department of Medicine, Queen's University, 102 Stuart Street, Kingston, ON K7L 2V6, Canada. Lougheed@kgh.kari.net
authors.forename: M Diane
authors.initials: MD
authors.lastname: Lougheed
mesh_terms: D001249:Asthma / Q000150:complications / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D016084:Bronchoconstriction; D004417:Dyspnea / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D009864:Ontario / Q000453:epidemiology; D010043:Outcome and Process Assessment, Health Care; D010465:Perception; D017410:Practice Guidelines as Topic; D015995:Prevalence; D012129:Respiratory Function Tests; D012720:Severity of Illness Index; D016896:Treatment Outcome