arrow Log In to View Account     |      
HOME
Johns Hopkins Medicine
Hopkins Logo


Disclaimer: CME certification for these activities has expired. All information is pertinent to the timeframe in which it was released.


Evolution of Asthma Therapy to Improve Outcomes


GOAL
To provide managed care professionals and physicians with practical information for diagnosing asthma and determining the best course of treatment for the management of asthma.

TARGET AUDIENCE
This activity is designed for pharmacy and therapeutic committee members, managed care decision makers, health care policy planners, and physicians in primary care and respiratory medicine.

LEARNING OBJECTIVES
After reading this issue, the participant should be able to:

  • Evaluate recent data showing that many patients continue to suffer poorly controlled asthma.
  • Summarize the 2002 National Heart, Lung, and Blood Institute (NHLBI) guidelines for asthma management.
  • Evaluate strategies for reducing humanistic and economic burdens of asthma.
  • Understand the NHLBI guidelines as they relate to stepwise care.

ACCREDITATION STATEMENT
This activity has been planned and produced in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education. The Johns Hopkins University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to sponsor continuing medical education (CME) for physicians. The Johns Hopkins University School of Medicine takes responsibility for the content, quality, and scientific integrity of this CME activity.

CREDIT DESIGNATION STATEMENT
The Johns Hopkins University School of Medicine designates this educational activity for a maximum of 1 hour in Category 1 credit toward the American Medical Association (AMA) Physicians' Recognition Award. Each physician should claim only those hours of credit that he/she actually spends on this educational activity. Credits are available until the expiration date of September 30, 2004.

This continuing education activity was produced under the supervision of Peter S. Creticos, MD, Associate Professor of Medicine; Clinical Director, Division of Allergy and Clinical Immunology, Johns Hopkins University School of Medicine, and Medical Director, Asthma and Allergy Diseases, Johns Hopkins Asthma and Allergy Center, Baltimore, Maryland.

This program is approved for 1 hour of credit (0.1 CEUs) and is co-sponsored by The University of Tennessee College of Pharmacy, which is approved by the American Council on Pharmaceutical Education (ACPE) as a provider of continuing pharmaceutical education. ACPE Program #064-999-02-224-H01.

This continuing pharmacy education activity was produced under the supervision of Glen E. Farr, PharmD, Associate Dean of Continuing Education, University of Tennessee College of Pharmacy.

This program is supported by an unrestricted educational grant from GlaxoSmithKline.

Publisher's Note and Disclaimer: The opinions expressed in this issue are those of the authors, presenters, and/or panelists and are not attributable to the publisher, editor, advisory board of Advanced Studies in Medicine, or The Johns Hopkins University School of Medicine or its Office of Continuing Medical Education. Clinical judgment must guide each professional in weighing the benefits of treatment against the risk of toxicity. Dosages, indications, and methods of use for products referred to in this issue are not necessarily the same as indicated in the package insert for the product and may reflect the clinical experience of the authors, presenters, and/or panelists or may be derived from the professional literature or other clinical sources. Consult complete prescribing information before administering.

Advanced Studies in Medicine (ISSN-1530-3004) is published by Galen Publishing, LLC, an HMG Company. P.O. Box 340, Somerville, NJ 08876. (908) 253-9001. Web site: www.galenpublishing.com. Copyright ©2001 by Galen Publishing, LLC. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, without first obtaining permission from the publisher. Bulk postage paid at Somerville, NJ Post Office and at additional mailing offices. Advanced Studies in Medicine is a registered trademark of The Healthcare Media Group, LLC. Printed on acid-free paper. BPA Membership applied for December 2000.

The contents of this issue of Advanced Studies in Medicine include 2 review articles based on the course curriculum for the Hopkins Symposia series titled "Evolution of Asthma Therapy to Improve Outcomes," and a case study.

FACULTY ADVISOR

    Peter S. Creticos, MD
    Associate Professor of Medicine
    Clinical Director, Division of Allergy and Clinical Immunology
    Johns Hopkins University School of Medicine
    Medical Director, Asthma and Allergy Diseases
    Johns Hopkins Asthma and Allergy Center
    Baltimore, Maryland
    • Dr Creticos reports receiving grants and/or research support from, serving as a consultant to, or being a member of the speakers' bureau for Aradigm, Aventis, AstraZeneca Pharmaceuticals LP, Dynavax Technologies, GlaxoSmithKline, Merck & Co, Inc, Pfizer, Pilot Therapeutics, Schering-Plough, and Stallergenes.

PARTICIPATING FACULTY

    David Stempel, MD
    Associate Clinical Professor of Pediatrics
    Virginia Mason Clinic
    University of Washington School of Medicine
    Seattle, Washington
    • Dr Stempel reports serving on the speakers' bureau for and as a consultant to GlaxoSmithKline.

Advanced Studies in Medicine provides disclosure information from contributing authors, lead presenters, and participating faculty. Advanced Studies in Medicine does not provide disclosure information from authors of abstracts and poster presentations. The reader shall be advised that these contributors may or may not maintain financial relationships with pharmaceutical companies.

Evolution of Asthma Therapy to Improve Outcomes
Peter S. Creticos, MD *

Basic and clinical research continues to reveal new insights that are dramatically increasing the ability to provide quality care to patients with asthma. Despite these advances, results of a recent nationwide survey of healthcare professionals and patients with asthma show that asthma care in the United States is suboptimal. Substantial proportions of patients have daily symptoms, frequent exacerbations and requirement for emergency care, and significant activity limitations because of asthma. These findings are troublesome in view of the availability of effective therapies that can control asthma in most patients. In 2002, the National Asthma Education and Prevention Program (NAEPP) updated their 1997 guidelines for asthma management in efforts to address the shortcomings in asthma care in the United States and to give healthcare providers practical guidance reflecting the most recent research.

This issue of Advanced Studies in Medicine, comprises 2 review articles based on the course curriculum for the Hopkins Symposia Series titled "Evolution of Asthma Therapy to Improve Outcomes," as well as a case study. The issue considers recent developments in asthma management in the context of the 1997 guidelines and the 2002 updated guidelines. The first article, "The NHLBI Guidelines: Where Do We Stand and What Is the New Direction From the NAEPP?" reviews the 1998 data that in part prompted revision of the 1997 NAEPP guidelines and discusses the 2002 revisions intended to improve asthma management. The 2002 revision to the NAEPP guidelines will potentially help to address some of the shortfalls in asthma care—but only if its recommendations are incorporated into day-to-day clinical practice. The 2002 revision emphasizes the importance of dual-controller therapy with both anti-inflammatory and bronchodilating properties for persistent asthma and reinforces the favorable risk-benefit ratio of inhaled corticosteroids in children.

In the second article titled "Asthma Management: Optimizing Treatment for a Disease of Variable Intensity," Dr David Stempel considers the management of patients with mild asthma in the context of the NAEPP guidelines. Growing evidence shows that patients who, based on selected indices, appear to have mild asthma may actually have more severe disease. Furthermore, studies show that patients with mild asthma—even those meeting criteria for having mild intermittent asthma that, according to guidelines, does not warrant daily controller therapy—benefit significantly from daily therapy with inhaled corticosteroids or combinations of inhaled corticosteroids and long-acting beta agonists. Dr Stempel challenges healthcare providers to assess more carefully patients with seemingly mild asthma to ensure that goals of asthma therapy are being fulfilled in this patient population. He also provides a case report of a patient with seemingly mild asthma who benefitted from daily controller therapy, stressing the need for multiple measures of asthma severity when determining treatment.

The information in this issue will help to improve the ability of healthcare workers to provide quality care for patients with asthma.

*Associate Professor of Medicine; Clinical Director, Division of Allergy and Clinical Immunology, Johns Hopkins University School of Medicine, and Medical Director, Asthma and Allergy Diseases, Johns Hopkins Asthma and Allergy Center, Baltimore, Maryland.





Johns Hopkins Advanced Studies in Medicine (ISSN-1558-0334), is published by Galen Publishing, LLC, d/b/a ASiM, PO Box 340, Somerville, NJ 08876. (908) 253-9001. Copyright ©2012 by Galen Publishing. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, without first obtaining permission from the publisher. ASiM is a registered trademark of The Healthcare Media Group, LLC.