Asthma has long been recognized as a worldwide non-communicable disease of importance. Within the population of asthmatics, there is a subgroup of individuals at high risk for complications, exacerbations, and a poor quality of life. These individuals are classified with severe asthma and they account for 5-15% of asthmatics in the USA and the world (Chung 2014, Zein et al 2015, WHO asthma fact sheet 2011). Severe asthma, as defined by the American Thoracic Society and European Respiratory Society (ATS/ERS) clinical practice guidelines, is asthma requiring treatment with high dose inhaled corticosteroids (ICS) and a second controller during the prior year, and/or oral steroids for at least half of the prior year to prevent symptoms from
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Severe asthma can also be described as uncontrolled despite reliance on ICS or frequent oral steroid use (Thomson 2014). Most of these population numbers are based on questionnaires investigating reported symptoms, particularly the presence of wheezing to assess global asthma burden. Wheezing notoriously over diagnoses asthma so may create a slightly higher prevalence than the population truly represents. According to information from the CDC and Environmental Protection Agency, in 2011, there were 25.9 million individuals in the USA including 7.1 million children diagnosed with asthma (EPA fact sheet 2011). In a similar effort in 2013, the Centers for Disease Control and Prevention (CDC) found asthma prevalence of 7.3% in America with 8.3% prevalence in children and 7% prevalence in adults. In the black population in the US there was an almost 50% increase in asthma diagnoses over the last 10 years. Epidemiologic research is ongoing to look at environmental and social influences on race patterns in asthma prevalence …show more content…
This remained high when adjusted for patient demographics. Recent exacerbation was defined as an ED visit or overnight hospitalization. Increased risk also remained significant if patients required oral corticosteroids in the 3 months preceding baseline for this study. Other factors suggesting high risk included prior pneumonia, intubation, and post bronchodilator FVC less than 70% predicted. Additional predictors of exacerbations in children included non-white ethnicity and presence of more than 3 allergic triggers. (Chipps TENOR Cur respire care
Severe asthma can also be described as uncontrolled despite reliance on ICS or frequent oral steroid use (Thomson 2014). Most of these population numbers are based on questionnaires investigating reported symptoms, particularly the presence of wheezing to assess global asthma burden. Wheezing notoriously over diagnoses asthma so may create a slightly higher prevalence than the population truly represents. According to information from the CDC and Environmental Protection Agency, in 2011, there were 25.9 million individuals in the USA including 7.1 million children diagnosed with asthma (EPA fact sheet 2011). In a similar effort in 2013, the Centers for Disease Control and Prevention (CDC) found asthma prevalence of 7.3% in America with 8.3% prevalence in children and 7% prevalence in adults. In the black population in the US there was an almost 50% increase in asthma diagnoses over the last 10 years. Epidemiologic research is ongoing to look at environmental and social influences on race patterns in asthma prevalence …show more content…
This remained high when adjusted for patient demographics. Recent exacerbation was defined as an ED visit or overnight hospitalization. Increased risk also remained significant if patients required oral corticosteroids in the 3 months preceding baseline for this study. Other factors suggesting high risk included prior pneumonia, intubation, and post bronchodilator FVC less than 70% predicted. Additional predictors of exacerbations in children included non-white ethnicity and presence of more than 3 allergic triggers. (Chipps TENOR Cur respire care