Viewpoint: Asthma Often Missed in Older Patients
Viewpoint: Asthma Often Missed in Older Patients
This viewpoint offers commentary on important clinical research in the area of pharmacy.
Barua P, O'Mahony MS
Drugs Aging. 2005;22(12):1029-1059
The incidence of asthma in the United States continues to rise. While often thought of as a disease affecting only children, asthma can continue into adulthood and in many cases is not even problematic until well into adulthood.
Unfortunately, asthma is often under-recognized, misdiagnosed, and undertreated in the older population. One reason is that symptoms of wheezing and bronchospasm, which are suggestive of asthma, are not universally present in older patients. Other diagnoses that can mimic some of the symptoms of asthma include "bronchoirritability syndrome," chronic obstructive pulmonary disease, chronic aspiration, gastroesophageal reflux, and tracheobronchial tumors.
The presence of comorbid diseases in the older population can further complicate the clinician's ability to definitively diagnose asthma. The presence of variable symptoms that may be worse in the evening and are provoked by triggers remains the hallmark for asthma.
Once asthma is diagnosed, treatment of the older population presents its own unique challenges because of the common presence of comorbid disease, cognitive impairment, and physical limitations (eg, inability to use inhaler devices). As with the management of asthma in younger patients, a stepwise approach is suggested for treating older patients.
The authors of this article provide an overview of the pharmacologic therapies that are available for treating asthma, such as inhaled corticosteroids and long-acting beta-2 agonists, offering important caveats that need to be considered with older patients.
Each subpopulation of patients presents its own unique considerations. This review provides important insights into the pharmacologic management of asthma in older patients. Pharmacists and other clinicians who interact closely with these patients must be alert to the nuances of treating this patient population.
Abstract
This viewpoint offers commentary on important clinical research in the area of pharmacy.
Overcoming Gaps in the Management of Asthma in Older Patients: New Insights
Barua P, O'Mahony MS
Drugs Aging. 2005;22(12):1029-1059
Study Summary
The incidence of asthma in the United States continues to rise. While often thought of as a disease affecting only children, asthma can continue into adulthood and in many cases is not even problematic until well into adulthood.
Unfortunately, asthma is often under-recognized, misdiagnosed, and undertreated in the older population. One reason is that symptoms of wheezing and bronchospasm, which are suggestive of asthma, are not universally present in older patients. Other diagnoses that can mimic some of the symptoms of asthma include "bronchoirritability syndrome," chronic obstructive pulmonary disease, chronic aspiration, gastroesophageal reflux, and tracheobronchial tumors.
The presence of comorbid diseases in the older population can further complicate the clinician's ability to definitively diagnose asthma. The presence of variable symptoms that may be worse in the evening and are provoked by triggers remains the hallmark for asthma.
Once asthma is diagnosed, treatment of the older population presents its own unique challenges because of the common presence of comorbid disease, cognitive impairment, and physical limitations (eg, inability to use inhaler devices). As with the management of asthma in younger patients, a stepwise approach is suggested for treating older patients.
The authors of this article provide an overview of the pharmacologic therapies that are available for treating asthma, such as inhaled corticosteroids and long-acting beta-2 agonists, offering important caveats that need to be considered with older patients.
Viewpoint
Each subpopulation of patients presents its own unique considerations. This review provides important insights into the pharmacologic management of asthma in older patients. Pharmacists and other clinicians who interact closely with these patients must be alert to the nuances of treating this patient population.
Abstract