Guidelines management of asthma in a busy urban practice.
OBJECTIVE
The purpose of this article is to review how optimal asthma management can be applied in a variety of clinical settings that are used to care for high-risk, urban asthma patients, especially those who live in the inner city, utilizing the 2007 National Heart, Lung, and Blood Institute/National Asthma Education Prevention Program 'Guidelines for the diagnosis and management of asthma', and adapting them to be applied in a variety of urban clinical settings, independent of practice infrastructure.


RESULTS
Previous asthma guidelines stressed asthma severity classification. A renewed focus on asthma control has led to better asthma outcomes. Consequently, it was deemed necessary to establish a new asthma paradigm that characterizes both asthma severity and control within the context of current impairment and future risk. This new paradigm can be effectively applied to high-risk, inner-city asthma patients, while allowing for individualization of care within systems of varied healthcare delivery infrastructures.


CONCLUSIONS
Assessment of asthma severity and control, with special emphasis on literacy and ethno-cultural beliefs and philosophies, will facilitate appropriate adaptations of long-term asthma management to provide optimal outcomes in urban asthmatics. It is essential to anticipate the worst-case, while planning for the best-case scenario.
Foggs
Michael B
MB
Advocate Health Centers, Advocate Health Care, Chicago, Illinois 60616, USA. immunotype@aol.com
D000293:Adolescent; D000328:Adult; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000175:diagnosis / Q000208:ethnology / Q000517:prevention & control / Q000628:therapy*; D002648:Child; D019468:Disease Management; D004522:Educational Status; D006801:Humans; D054555:National Heart, Lung, and Blood Institute (U.S.); D010353:Patient Education as Topic; D011204:Poverty Areas; D017410:Practice Guidelines as Topic; D012129:Respiratory Function Tests; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014481:United States; D014505:Urban Population
D018927:Anti-Asthmatic Agents