Asthma and Personalized Medicine Care

After decades of improvement in diagnosis techniques and new treatment modalities, asthma outcomes have stalled. Mortality has decreased in developed countries, but despite effective therapies, hospitalizations, exacerbations and symptom control remain sub-optimal.The disease burden remains huge and in Iran 8 to 9 percent of population suffer from asthma. In controlled trials, most patients gain high levels of control, but in ‘real-life’ routine clinical practice most patients do not. Avoidable factors are found in most asthma deaths and hospital admissions.Audits of prescribing patterns in primary care clinicians often show prescribing not in accord with guideline recommendations, including overprescribing of Salbutamol (SABA), underuse of inhaled corticosteroids (ICS), use of long-acting β2-agonists (LABAs) as monotherapy and over-use of Injections of corticosteroids.The most common reasons for poor control are that many patients either do not take treatment regularly or have poor inhaler technique. Unfortunately non-adherence is a common form of self-management in asthmatic patients. Many patients use their inhaler badly, most will make some errors and many make ‘critical errors’ that result in little or no medication delivery and it s too important for physician to educate each individual patient how to use inhalers and spacer .Psychological dysfunction is six times as common in people with asthma, and asthma-related quality of life correlates more closely with psychological and social status than lung function or treatment step.It is unlikely in the foreseeable future that we can ‘cure’ asthma, but we should be able to characterize our patients individually, in particular those who, for one reason or another, are not doing well, and for most there will be effective strategies for improving outcomes. However, the most effective intervention(s) will vary greatly between patients, and a ‘one size fits all’ approach will no longer suffice. We now need to put our information together into coherent, patient-orientated personalized care.

کلیدواژه ها:

Asthma ، Patient Care ، Personalized Medicine