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Variability in asthma: symptom perception, care, and outcomes

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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.

L’asthme demeure un problème de santé respiratoire à l’échelle mondiale. Des variations substantielles de l’évolution de l’asthme persistent au Canada malgré la diffusion de lignes directrices nationales en matière de traitement. De nombreux facteurs et leur interaction contribuent probablement à ces variations, notamment la prévalence de l’asthme, la gravité, la reconnaissance des symptômes, le comportement d’autogestion, l’accès aux soins et le traitement. Cet article présente une synthèse de la physiologie de la perception des symptômes de l’asthme, en particulier le rôle de l’hyperinflation pulmonaire dynamique (HD) dans la perception de l’intensité et de la qualité de la dyspnée, et le lien entre une perception inadéquate et l’asthme menaçant pour la vie. Il fait aussi le point sur l’amplitude et les corrélats de la variation régionale des taux de visites à l’urgence et des hospitalisations pour cause d’asthme en Ontario.

Document Type: Research Article

Publication date: January 1, 2007

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  • Published since 1929, this monthly journal reports current research in all aspects of physiology, nutrition, pharmacology, and toxicology, contributed by recognized experts and scientists. It publishes symposium reviews and award lectures and occasionally dedicates entire issues or portions of issues to subjects of special interest to its international readership.
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