Imperial College London
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DrLouiseFleming

Faculty of Medicine, National Heart & Lung Institute

Honorary Senior Research Fellow
 
 
 
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Contact

 

+44 (0)20 7352 8121 ext 2938l.fleming

 
 
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Location

 

Department of Respiratory PaediaRoyal BromptonRoyal Brompton Campus

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Summary

 

Publications

Citation

BibTex format

@article{Hew:2020:10.1016/j.jaip.2020.02.036,
author = {Hew, M and Menzies-Gow, A and Hull, JH and Fleming, L and Porsbjerg, C and Brinke, AT and Allen, D and Gore, R and Tay, TR},
doi = {10.1016/j.jaip.2020.02.036},
journal = {Journal of Allergy and Clinical Immunology: In Practice},
pages = {2222--2233},
title = {Systematic assessment of difficult-to-treat asthma: principles and perspectives},
url = {http://dx.doi.org/10.1016/j.jaip.2020.02.036},
volume = {8},
year = {2020}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Difficult-to-treat asthma affects a minority of adults and children with asthma but represents a challenging mix of misdiagnosis, multimorbidity, inadequate self-management, severe airway pathobiology, and treatment complications. Management of these patients extends beyond asthma pharmacotherapy, because multiple other patient-related domains need to be addressed as well. Such complexity can hinder adequate clinical assessment even when performed in specialist practice. Systematic assessment undertaken by specialized multidisciplinary teams brings a broad range of resources to bear on patients with difficult-to-treat asthma. Although the concept of systematic assessment is not new, practices vary considerably and implementation is not universal. Nevertheless, assessment protocols are already in place in several institutions worldwide, and outcomes after such assessments have been highly encouraging. This review discusses the rationale, components, and benefits of systematic assessment, outlining its clinical utility and the available evidence for improved outcomes. It describes a range of service configurations and assessment approaches, drawing examples from severe asthma centers around the world to highlight common essential elements. It also provides a framework for establishing such services and discusses practical considerations for implementation.
AU  - Hew,M
AU  - Menzies-Gow,A
AU  - Hull,JH
AU  - Fleming,L
AU  - Porsbjerg,C
AU  - Brinke,AT
AU  - Allen,D
AU  - Gore,R
AU  - Tay,TR
DO  - 10.1016/j.jaip.2020.02.036
EP  - 2233
PY  - 2020///
SN  - 2213-2198
SP  - 2222
TI  - Systematic assessment of difficult-to-treat asthma: principles and perspectives
T2  - Journal of Allergy and Clinical Immunology: In Practice
UR  - http://dx.doi.org/10.1016/j.jaip.2020.02.036
UR  - https://www.ncbi.nlm.nih.gov/pubmed/32173508
UR  - http://hdl.handle.net/10044/1/78868
VL  - 8
ER  -
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