title: PILL Series. The 'problematic' asthma patient.
abstract: Asthma is a reversible chronic inflammatory disorder of the airways that can be effectively controlled without causing any lifestyle limitation or burden on the quality of life of the majority of asthma patients. However, persistently uncontrolled asthma can be frustrating for both the patient and the managing physician. Patients who fail to respond to high-intensity asthma treatment fall into the category of 'problematic' asthma, which is further subdivided into 'difficult' asthma and 'severe refractory' asthma. Establishing the correct diagnosis of asthma and addressing comorbidities, compliance, inhaler technique and environmental triggers are essential when dealing with 'problematic' asthma patients. A systemic approach is also crucial in managing such patients. This is pertinent for general practitioners, as the majority of asthma patients are diagnosed and managed at the primary care level.
authors.affiliation: SingHealth Residency (Internal Medicine), Changi General Hospital, Singapore.
authors.forename: Swee Leng
authors.initials: SL
authors.lastname: Kui
authors.affiliation: Care and Health Integration, Changi General Hospital, Singapore.
authors.forename: Choon How
authors.initials: CH
authors.lastname: How
authors.affiliation: SingHealth Residency (Internal Medicine), Changi General Hospital, Singapore ; Respiratory and Critical Care Medicine, Changi General Hospital, Singapore.
authors.forename: Jansen
authors.initials: J
authors.lastname: Koh
mesh_terms: D001249:Asthma / Q000523:psychology / Q000628:therapy*; D015897:Comorbidity; D003937:Diagnosis, Differential; D004777:Environment; D058005:General Practitioners; D006801:Humans; D007249:Inflammation; D008297:Male; D008875:Middle Aged; D009330:Nebulizers and Vaporizers; D010349:Patient Compliance; D011320:Primary Health Care / Q000379:methods; D015272:Pulmonary Medicine / Q000379:methods*; D011788:Quality of Life
keywords: asthma; difficult; primary care; problematic; severe refractory