Otolaryngology, Respiratory, and Allergic
Chronic Asthma
September 2001
Clinical Focus*
- Does chronic use of inhaled corticosteroids (ICS) improve long-term outcomes for children with mild to moderate asthma, compared to "as needed" beta 2 agonists, long-acting beta 2 agonists, theophylline, cromolyn/nedocromil, combinations of the above drugs?
- What are the long-term adverse effects of chronic ICS use in children on the following outcomes: vertical growth, bone mineral density, ocular toxicity, and suppression of adrenal pituitary axis?
- For patients with mild to moderate asthma, does early initiation of long-term controller therapy (i.e., ICS) prevent progression of asthma, as indicated by changes in lung function or severity of symptoms?
- For patients with moderate asthma who are receiving ICS, does adding another long-term control agent improve outcomes?
- Does routinely adding antibiotics to standard care improve the outcomes of treatment for acute exacerbation of asthma?
- Does the addition of antibiotics to standard care in the following populations improve the outcomes of treatment for an acute exacerbation of asthma?
- Compared to medical management alone, does the use of a written asthma action plan improve outcomes?
- Compared to a written action plan based on symptoms, does use of a written action plan based on peak flow monitoring improve outcomes?
- What are the outcomes of a written action plan for daily use compared to a written action plan for exacerbation use only?
- What are the outcomes of peak flow monitoring without an action plan to medical management alone?
- What are the outcomes of chronic peak flow monitoring compared to exacerbation only peak flow monitoring?
- What are the relative outcomes of alternative schedules of peak flow monitoring?
*Addressed in the summary or evidence report.
Management of Chronic Asthma
Summary (Publication No. 01-E043, September 2001)
Evidence Report (Publication No. 01-E044, September 2001)
(File Download)
EPC: Blue Cross and Blue Shield Association TEC
Topic Nominators: National Heart, Lung, and Blood Institute, American Academy of Pediatrics, American Association of Family Physicians
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