Difficult asthma: Assessment and management, Part 1
A minority of asthma patients have disease that proves difficult to control with usual medications and experience ongoing symptoms, poor quality of life, and limitations in activity and/or frequent asthma exacerbations. This group of patients accounts for much of the expense associated
with asthma care and is the focus of national and international collaborative study groups. Distinguishing between “difficult-to-manage asthma” and truly “therapy-resistant asthma” is helpful and promotes a systematic consideration of contributory factors. Critical
evaluation of factors contributing to difficult-to-manage asthma including adverse environment, comorbidities, nonadherence, and incorrect diagnosis is recommended in a systematic fashion in Part 1 of this contribution.
Keywords: Aggravating conditions; allergic bronchopulmonary aspergillosis; allergic sensitivities; alternative diagnoses; aspirin-exacerbated respiratory disease; difficult asthma; gastroesophageal reflux disease; nonadherence; severe asthma; vocal cord dysfunction
Document Type: Research Article
Affiliations: Partners Asthma Center and the Allergy and Clinical Immunology Division at Massachusetts General Hospital and the Pulmonary and Critical Care Division at Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
Publication date: 01 July 2012
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