Difficult To Treat Asthma - Clinical Essentials

This book provides a practical, stepwise, evidence-based approach to effective management of patients with difficult to treat asthma. The impact of asthma on morbidity and healthcare utilization increases exponentially with severity. Severe refractory asthma accounts for less than 5% of all asthma. Its prevalence, however, is often overestimated as there are several other confounding factors that make asthma 'difficult to treat'. Many novel (albeit expensive) therapies are now available and providers caring for patients with severe asthma are charged with selecting the best evidence treatment. This calls for complex and nuanced decision-making. Whether people with asthma gain and maintain control over their condition depends not only on the availability of effective drugs, but also multiple patient and healthcare provider behaviors. Therefore, now more than ever, it has become increasingly important to differentiate "difficult" from "severe refractory" asthma to allow identification of patients most likely to benefit from these therapies.  This volume delves into the current understanding of mechanisms and increasingly recognized heterogeneity of this complex disease. It discusses a structured approach to identification and optimization of factors contributing to poor asthma control, including nonadherence, comorbidities and occupational/environmental triggers. The book includes 'state of the art' reviews on recent advances in traditional and targeted asthma therapies, as well as a glimpse into what the future may hold. Highlights include a comprehensive guide to management of severe asthma in children and pregnancy, as well as practical considerations to management of asthma based on different clinical phenotypes. Each chapter is authored by leading experts in the field who share their own clinical approach.  This is an ideal guide for clinical pulmonologists and allergist/immunologists, as well as primary care providers, physician extenders in specialty practice, physicians in pulmonary/allergy training, and even industry partners.  

List of contents

Scope of the problem, definition and pathophysiology.- Is it Asthma? Recognizing asthma mimics.- Beyond Refills: Promoting Adherence to Optimize Outcomes.- Addressing Comorbidities in Difficult Asthma.- Evaluation and Management of Work-Related Asthma.- Advances in Inhaled Medications.- Heterogeneity in Severe asthma.- Biomarkers, Targeted Therapies, Biologics and Bronchial Thermoplasty.- Practical Considerations in Management of Allergic Asthma.- Practical considerations in the management of eosinophilic asthma.- Practical considerations in management of non-eosinophilic asthma.- Practical considerations in management of obesity associated asthma.- Severe asthma in pregnancy: Special considerations.- Severe asthma in childhood: Special considerations.- High-risk asthma clinic: Putting it all together.- Difficult Asthma: Unmet Needs and Future Directions. 

About the author

Sandhya Khurana, MD is an Associate Professor of Medicine at the University of Rochester and the Co-Director of Mary Parkes Center for Asthma, Allergy & Pulmonary Care. Dr. Khurana is an adult pulmonologist with a specialized focus in management of severe and difficult to treat asthma. She is the immediate past chair of the Airways Disorders NetWork of the American College of Chest Physicians. Dr. Khurana has chaired asthma-focused sessions and participated as faculty at national and international meetings. She also serves on the American Thoracic Society and European Respiratory Society joint taskforce on severe asthma. 

Fernando Holguin, MD., MPH., is Professor of Medicine and Pediatrics and the Director of the Asthma Clinical and Research Programs at the University of Colorado. Dr Holguin has been involved in asthma clinical and translational research for over 20 years. His research work primarily focuses on the intersection of obesity and asthma. Dr. Holguin co-chairs the American Thoracic Society and European Respiratory Society taskforce on Severe Asthma. 

Summary

This book provides a practical, stepwise, evidence-based approach to effective management of patients with difficult to treat asthma. The impact of asthma on morbidity and healthcare utilization increases exponentially with severity. Severe refractory asthma accounts for less than 5% of all asthma. Its prevalence, however, is often overestimated as there are several other confounding factors that make asthma ‘difficult to treat’. Many novel (albeit expensive) therapies are now available and providers caring for patients with severe asthma are charged with selecting the best evidence treatment. This calls for complex and nuanced decision-making. Whether people with asthma gain and maintain control over their condition depends not only on the availability of effective drugs, but also multiple patient and healthcare provider behaviors. Therefore, now more than ever, it has become increasingly important to differentiate “difficult” from “severe refractory” asthma to allow identification of patients most likely to benefit from these therapies.  This volume delves into the current understanding of mechanisms and increasingly recognized heterogeneity of this complex disease. It discusses a structured approach to identification and optimization of factors contributing to poor asthma control, including nonadherence, comorbidities and occupational/environmental triggers. The book includes ‘state of the art’ reviews on recent advances in traditional and targeted asthma therapies, as well as a glimpse into what the future may hold. Highlights include a comprehensive guide to management of severe asthma in children and pregnancy, as well as practical considerations to management of asthma based on different clinical phenotypes. Each chapter is authored by leading experts in the field who share their own clinical approach.  This is an ideal guide for clinical pulmonologists and allergist/immunologists, as well as primary care providers, physician extenders in specialty practice, physicians in pulmonary/allergy training, and even industry partners.  

Additional text

 “The book is intended as a practical resource for health professionals who treat asthma. … Any clinician who cares for patients with asthma will find valuable information. … This is an excellent book and a practical, useful resource for both generalists and specialists.” (Dennis Ledford, Doody’s Book Reviews, March 14, 2020)

Report

 "The book is intended as a practical resource for health professionals who treat asthma. ... Any clinician who cares for patients with asthma will find valuable information. ... This is an excellent book and a practical, useful resource for both generalists and specialists." (Dennis Ledford, Doody's Book Reviews, March 14, 2020)

Product details

• Assisted by: Holguin (Editor), Holguin (Editor), Fernando Holguin (Editor), Sandhy Khurana (Editor), Sandhya Khurana (Editor)
• Publisher: Springer, Berlin
• Languages: English
• Product format: Hardback
• Released: 01.01.2019
• EAN: 9783030208110
• ISBN: 978-3-0-3020811-0
• No. of pages: 334
• Dimensions: 159 mm x 245 mm x 21 mm
• Weight: 701 g
• Illustrations: XV, 334 p. 30 illus., 27 illus. in color.
• Series: Respiratory Medicine; Respiratory Medicine
• Subjects: Natural sciences, medicine, IT, technology > Medicine > Clinical medicine; B, Medicine, General practice, INTERNAL MEDICINE, Allgemeinmedizin / Familienmedizin, Respiratory organs—Diseases, Pneumology/Respiratory System, Primary care (Medicine), Primary Care Medicine