Monitoring Asthma

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ISBN: 9781574448559 | 1574448552
Cover: Hardcover
Copyright: 8/12/2005

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Hunter Medical Research Institute, New South Wales, Australia. Offers critical reviews of individual monitoring devices and their interpretation using established and innovative statistical techniques. Explores methods of self-monitoring and monitoring using the Internet. For researchers and clinicians.

Introduction

iii

Claude Lenfant

Preface

Contributors

vii

1. Symptoms: Monitoring, Perceptions

(18)

R.J. Adams, D.H. Wilson, and R.E. Ruffin

Asthma Symptoms

(2)

Purpose of Symptom Monitoring

(2)

Functional Limitation

(1)

Symptom Monitoring and Exacerbations

(3)

Symptom Perception

(2)

Symptom Scoring Systems

(2)

Framework

(1)

References

(6)

2. Quality of Life

(22)

Elizabeth F. Juniper

Introduction

(1)

Health-Related Quality of Life

(1)

Why do We Need to Measure Quality of Life in Asthma?

(1)

Quality of Life Impairments in Asthma

(2)

Selecting the Right Questionnaire for the Task

(2)

Interpretation of Quality of Life Data

(1)

Quality of Life in Clinical Trials

(1)

Quality of Life in Clinical Practice

(2)

Practical Considerations

(4)

Cultural Adaptations

(1)

Conclusion

(1)

References

(5)

3. Monitoring Cough: Diary, Electronic Monitoring and Significance in Asthma

(30)

Anne B. Chang

Introduction

(1)

General Issues on Cough as a Symptom and Outcome Measure

(1)

Measurements of Cough Severity

(6)

Significance of Cough in Asthma

(12)

Application (Case Study)

(1)

Summary

(1)

References

(9)

4. Electronic Monitoring of Lung Function in Asthma: Technical Aspects, Clinical Applications

(36)

Helen K. Reddel

Context of Electronic Spirometric and Peak Flow Monitoring

(1)

Types of Electronic Monitoring Devices

(16)

Performance Issues

(3)

Processing Issues

(3)

Uses of Electronic Monitoring Devices

(7)

Priorities in Use of Electronic Monitoring Devices

101

(1)

References

102

(5)

5. Asthma and Telemedicine

107

(16)

Claire Wainwright and Richard Wootton

Abstract

107

(1)

Introduction

108

(1)

What Is Telemedicine?

108

(1)

Why Telemedicine in Asthma?

109

(7)

Clinical Guidelines, Decision Support Tools and Clinical Information Systems

116

(1)

Promising Developments

117

(1)

Unanswered Research Questions

117

(1)

Other Issues

118

(1)

Conclusion

118

(1)

References

119

(4)

6. At-Home Monitoring of Serial Lung Function Using Statistical Process Control Theory and Charts

123

(22)

Peter B. Boggs, Fazel Hayati, and Donald J. Wheeler

Summary

123

(1)

Introduction

124

(2)

Basic Theory and Terminology

126

(6)

Clinical Examples

132

(6)

Discussion

138

(3)

Conclusion

141

(1)

References

141

(4)

7. Monitoring Adherence

145

(16)

Susan M. Sawyer

What Is Meant by Adherence?

147

(1)

Patterns of Adherence

147

(1)

Monitoring Adherence

148

(4)

Why Monitor Adherence?

152

(2)

How Much Is Enough?

154

(1)

Whose Problem Is Poor Adherence?

155

(1)

Monitoring Adherence Universally

155

(3)

References

158

(3)

8. Monitoring Asthma Triggers-Allergens

161

(46)

Euan Tovey and Tim O'Meara

Introduction

161

(1)

A Primer on Allergens

162

(7)

Exposure and Clinical Outcomes

169

(6)

Measuring Exposure to Allergens

175

(1)

Methods of Collecting Reservoir Allergen Sources

175

(5)

Methods of Collecting Aeroallergens

180

(3)

Types of Air Samplers

183

(2)

Measurement of Allergens and Visual Identification of Their Sources

185

(7)

Comments in Conclusion

192

(1)

References

193

(14)

9. Monitoring Asthma in the Workplace

207

(26)

Jean-Luc Malo, Catherine Lemiere, André Cartier, Manon Labrecque, and Denyse Gautrin

Introduction and Background

207

(5)

Monitoring

212

(13)

Conclusion

225

(1)

References

225

(8)

10. Monitoring Airway Hyperresponsiveness: Pharmacological Stimuli

233

(42)

Alan James

Introduction

233

(1)

Properties of Methacholine and Histamine

234

(4)

Methods of Testing

238

(3)

"Squeeze" Method for Infants

241

(1)

Factors Affecting Airway Responsiveness

242

(2)

Expression of Results and Reproducibility

244

(1)

The Use of Direct Stimuli to Diagnose Asthma

245

(3)

Detection of Asthma in Different Populations

248

(2)

Occupational Asthma

250

(1)

Comparisons with Indirect Challenge Agents

251

(1)

Relation of Direct Challenge Responses to Asthma Severity and Treatment

252

(2)

Relation and Relevance to Airway Pathology

254

(4)

Summary

258

(1)

References

259

(16)

11. Monitoring Airway Hyperresponsiveness: Indirect Stimuli—Exercise, Hypertonic Saline, Mannitol, and Adenosine Monophosphate

275

(50)

Sandra D. Anderson, John D. Brannan, Jörg D. Leuppi, and Heikki Koskela

Overview

275

(1)

Definition of Indirect Stimuli

276

(3)

Background to the Use of These Indirect Stimuli for Monitoring Airway Hyperresponsiveness

279

(4)

Relationship Between One Indirect Stimulus and Another

283

(2)

Role of Mediators in the Differences Between Indirect Stimuli and Direct Stimuli

285

(3)

Indications for Use of Indirect Stimuli

288

(8)

Clinical Evaluation Using Indirect Stimuli

296

(11)

Monitoring Changes to Allergen Avoidance and Exposure

307

(2)

Conclusions

309

(1)

References

310

(15)

12. Induced Sputum in Asthma

325

(24)

D.E. Shaw, M.A. Berry, R.H. Green, and I.D. Pavord

Introduction

325

(1)

Feasibility of Measuring Airway Inflammation

326

(4)

Methodology

330

(1)

Measurement Characteristics of Induced Sputum

331

(2)

Findings in Asthma

333

(2)

What Features of the Inflammatory Response Contribute to Disordered Airway Function?

335

(1)

How Does Eosinophilic Airway Inflammation Contribute to the Pathophysiology of Asthma?

336

(1)

Clinical Role for Monitoring Airway Inflammation

337

(4)

Future Directions

341

(1)

Summary

342

(1)

References

343

(6)

13. Exhaled Biomarkers in Monitoring Asthma

349

(14)

Ildiko Horvath

Introduction

349

(2)

Exhaled Gases

351

(4)

Mediators in Exhaled Breath Condensate

355

(1)

Summary

356

(1)

References

357

(6)

14. Monitoring Childhood Asthma

363

(20)

Peter D. Sly and Felicity S. Flack

Introduction

363

(1)

What Is Childhood Asthma?

364

(3)

What Are the Characteristics of a "Good Monitor?"

367

(1)

Monitoring Asthma in Infants

367

(3)

Monitoring Asthma in Pre-School Children

370

(4)

Monitoring Asthma in Older Children

374

(2)

References

376

(7)

15. Asthma Epidemics, Monitoring Mortality

383

(34)

Neil Pearce

Introduction

383

(4)

Assessing the Validity of Time Trends

387

(4)

Assessing Possible Explanations for Time Trends

391

(7)

Cohort and Case–Control Studies of Asthma Deaths

398

(12)

Summary

410

(1)

References

411

(6)

16. Monitoring Asthma in Populations

417

(48)

Guy B. Marks, Deborah F. Baker, and Margaret Williamson

Introduction

417

(1)

Purposes of Monitoring Asthma in Populations

418

(4)

Identification of Asthma for Monitoring Purposes

422

(2)

Monitoring Key Specific Indicators

424

(25)

Conclusions

449

(1)

References

449

(16)

17. Role of Pharmacists in Asthma Monitoring

465

(38)

C.L. Armour, B. Sahli, S. Bosnic-Anticevich, and I. Krass

Pharmacists in the Health Care System

465

(1)

Pharmacists and Chronic Diseases

466

(1)

Current Issues with Asthma Management: Where Can the Pharmacist Help?

467

(3)

Current Trends in Pharmacy Management of Asthma

470

(1)

Pharmaceutical Care and Asthma

470

(1)

Optimizing Pharmacy-based Interventions and Outcomes

471

(9)

Specific Monitoring of Asthma in the Pharmacy Setting

480

(7)

Monitoring Outcomes

487

(8)

Conclusion

495

(1)

References

495

(8)

18. Monitoring the Impact of Asthma Drug Therapy: Database Studies

503

(28)

Pierre Ernst and Sang Suissa

Introduction

503

(1)

Advantages and Limitations of Database Studies

504

(2)

Adverse Effects of Inhaled B,-Agonists

506

(5)

Benefits of Inhaled Corticosteroids

511

(2)

Risks of Inhaled Corticosteroids

513

(3)

Asthma Prognosis

516

(1)

Methodological Issues in Observational Study Designs

516

(8)

Conclusion

524

(1)

References

525

(6)

Index

531

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Monitoring Asthma

Summary

Table of Contents

Supplemental Materials