0
Editorial |

Inhaled Corticosteroid Dose Adjustment in Mild Persistent Asthma

George T. O’Connor, MD, MS; Joan Reibman, MD
JAMA. 2012;308(10):1036-1037. doi:10.1001/2012.jama.11405.
Text Size: A A A
Published online

Extract

Regular use of controller medications, such as inhaled corticosteroids (ICS), improves outcomes in patients with asthma. The importance of daily use of ICS is emphasized in asthma management guidelines.1 However, ensuring that patients with asthma adhere to daily use of ICS, even when asymptomatic, is a challenge. Therefore, clinicians spend substantial time and energy educating patients with asthma about the importance of daily use of ICS. The latter medications, however, do not lead to the immediate relief of asthma symptoms associated with short-acting rescue bronchodilators, such as albuterol, so patients often neglect to take ICS due to the incorrect perception that they do not help. This frequently observed pattern of poor adherence to daily use of ICS has led to the hypothesis that tying use of ICS to the as-needed use of a short-acting bronchodilator may lead to better asthma control for patients with relatively mild asthma. Combining use of ICS with as-needed short-acting bronchodilators may improve asthma control by increasing the patient's motivation to take ICS and by focusing ICS therapy on periods when symptoms of asthma (which vary over time due to environmental factors) are more prounounced. This as-needed ICS strategy could also potentially reduce costs and patient inconvenience by avoiding use of ICS when asthma is not bothersome.

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
/>
First page PDF preview

Figures

Tables

References

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics
PubMed Articles
Jobs
JAMAevidence.com

Users' Guides to the Medical Literature
Clinical Resolution

Users' Guides to the Medical Literature
Clinical Scenario

brightcove.createExperiences();