Allercy and Asthma Health
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The Official Publication of AAN - MA

Difficult Asthma or Difficult Patient?

National guidelines on the treatment of asthma clearly state asthma can be controlled with proper care and management. So how come so many people still have problems with their asthma? Irish researchers asked this question in a study involving 182 patients referred to a clinic specializing in difficult-to-treat asthma. The answer? In a lot of cases, it isn't the asthma that's at fault—it's the patient.

They found 35% of these Irish patients filled fewer than half of their prescribed inhaled combination therapy, 21% filled more than they were prescribed, and 45% filled between half and all of the medication they were prescribed. In patients who were on a maintenance course of oral prednisolone, blood levels of cortisol and prednisolone showed 45% were not taking the medication as prescribed.

When questioned further, most patients admitted they were not following their doctor's orders. The researchers believe the solution is for doctors and other health care professionals to more carefully question patients with difficult asthma to see if the reason why the asthma is such a problem is because of poor adherence to medications.

"Determining whether the patient is taking medications as prescribed is of utmost importance before moving to more aggressive and expensive treatments," Dr. Liam Heaney was quoted as saying.

The study appeared in the Nov. 1, 2009 edition of the American Journal of Respiratory and Critical Care Medicine.
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