Abstract
The symptoms of many asthmatic patients are poorly controlled, and there are several reasons why this may be so. Doctors fail to find out about symptoms that asthmatic patients are experiencing. Doctors wrongly assume that regular use of bronchodilators in small doses is satisfactory treatment for asthma and that taking high doses of bronchodilator in an asthma attack may be dangerous. Doctors think that inhaled steroids may be dangerous and are reluctant to use them in effective doses. Doctors do not check that patients can use their inhalers properly and do not make enough use of large volume spacers, the best available method for giving inhaled asthma treatment. Doctors undermine patients' confidence in advice on treatment by failing to ensure that consistent advice is given and often make the management of asthma more troublesome for the patient than the symptoms of asthma.
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Selected References
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- Balfour-Lynn L. Growth and childhood asthma. Arch Dis Child. 1986 Nov;61(11):1049–1055. doi: 10.1136/adc.61.11.1049. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Delamothe T. Wanted: guidelines that doctors will follow. BMJ. 1993 Jul 24;307(6898):218–218. doi: 10.1136/bmj.307.6898.218. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Fuglsang G., Pedersen S. Comparison of Nebuhaler and nebulizer treatment of acute severe asthma in children. Eur J Respir Dis. 1986 Aug;69(2):109–113. [PubMed] [Google Scholar]
- Geddes D. M. Inhaled corticosteroids: benefits and risks. Thorax. 1992 Jun;47(6):404–407. doi: 10.1136/thx.47.6.404. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Jones K. P., Bain D. J., Middleton M., Mullee M. A. Correlates of asthma morbidity in primary care. BMJ. 1992 Feb 8;304(6823):361–364. doi: 10.1136/bmj.304.6823.361. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Morgan M. D., Singh B. V., Frame M. H., Williams S. J. Terbutaline aerosol given through pear spacer in acute severe asthma. Br Med J (Clin Res Ed) 1982 Sep 25;285(6345):849–850. doi: 10.1136/bmj.285.6345.849. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Newman S. P., Millar A. B., Lennard-Jones T. R., Morén F., Clarke S. W. Improvement of pressurised aerosol deposition with Nebuhaler spacer device. Thorax. 1984 Dec;39(12):935–941. doi: 10.1136/thx.39.12.935. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Newman S. P., Morén F., Trofast E., Talaee N., Clarke S. W. Deposition and clinical efficacy of terbutaline sulphate from Turbuhaler, a new multi-dose powder inhaler. Eur Respir J. 1989 Mar;2(3):247–252. [PubMed] [Google Scholar]
- Silverman M., Connolly N. M., Balfour-Lynn L., Godfrey S. Long-term trial of disodium cromoglycate and isoprenaline in children with asthma. Br Med J. 1972 Aug 12;3(5823):378–381. doi: 10.1136/bmj.3.5823.378. [DOI] [PMC free article] [PubMed] [Google Scholar]