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  • Title: Guidelines management of asthma in a busy urban practice.
    Author: Foggs MB.
    Journal: Curr Opin Pulm Med; 2008 Jan; 14(1):46-56. PubMed ID: 18043275.
    Abstract:
    PURPOSE OF REVIEW: The purpose of this article is to review how optimal asthma management can be applied in a variety of clinical settings that are used to care for high-risk, urban asthma patients, especially those who live in the inner city, utilizing the 2007 National Heart, Lung, and Blood Institute/National Asthma Education Prevention Program 'Guidelines for the diagnosis and management of asthma', and adapting them to be applied in a variety of urban clinical settings, independent of practice infrastructure. RECENT FINDINGS: Previous asthma guidelines stressed asthma severity classification. A renewed focus on asthma control has led to better asthma outcomes. Consequently, it was deemed necessary to establish a new asthma paradigm that characterizes both asthma severity and control within the context of current impairment and future risk. This new paradigm can be effectively applied to high-risk, inner-city asthma patients, while allowing for individualization of care within systems of varied healthcare delivery infrastructures. SUMMARY: Assessment of asthma severity and control, with special emphasis on literacy and ethno-cultural beliefs and philosophies, will facilitate appropriate adaptations of long-term asthma management to provide optimal outcomes in urban asthmatics. It is essential to anticipate the worst-case, while planning for the best-case scenario.
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