The needs of older people with asthma (original) (raw)
Related papers
Undiagnosed asthma in older people: an underestimated problem
The Medical journal of Australia, 2005
WHAT WE NEED TO KNOW: Are older people with respiratory symptoms aware this could be asthma? Which explanations for undiagnosed asthma apply most commonly in older Australians with asthma? Can we improve awareness of asthma in older people with undiagnosed asthma? Is the possibility of asthma in older people firmly established on the general practitioners' radar screen? What reasons most often determine whether GPs perform spirometry in their practice? WHAT WE NEED TO DO: Conduct a representative population study to assess whether older Australians recognise respiratory symptoms as being asthma and are reporting these symptoms. Conduct and evaluate a pilot asthma health promotion program for older people. Conduct a controlled therapeutic trial of people with undiagnosed asthma to assess treatment benefits and produce treatment recommendations. Identify whether the prominence of asthma in older people can be brought to the attention of GPs. Analyse more carefully the issues assoc...
Asthma and older people in general practice
The Medical journal of Australia, 2005
WHAT WE NEED TO KNOW: Why is there undiagnosed and untreated asthma in older people in the community and in general practice? What patient, general practitioner and organisational factors contribute to this? Are current best practice guidelines appropriate for older people with asthma? WHAT WE NEED TO DO: Undertake broad community and general practice screening to identify characteristics of older people with undiagnosed asthma. Analyse GPs' perspectives and decision-making processes for older people with dyspnoea. Undertake targeted research in general practice, trialling decision-making frameworks for older patients with dyspnoea. Undertake appropriate and relevant community and GP awareness campaigns about the prevalence of asthma in older people. Analyse current best practice management of asthma, including self-management and the Asthma 3+ Visit Plan, in older people.
Intervention Educational intervention for older people with asthma : A randomised controlled trial
2013
Objectives: To improve the asthma control and adherence to asthma preventer medication of older people using the Patient Asthma Concerns Tool (PACT) to identify and address unmet needs and patient concerns. Methods: Community dwelling adults over 55 years, living in Victoria or New South Wales were recruited into a single-blind, parallel design, randomised-controlled trial comparing person-centred education including device technique, versus written information-only education. Fifty-eight participants randomised to the intervention group and 56 to the control completed participation. Outcome measures: asthma control, adherence to preventer medication, asthma related quality of life, asthma exacerbations and written action plan ownership were assessed at baseline, and 3 and 12 months post intervention. Results: Intervention participants experienced improvements in asthma control, adherence to asthma preventer medication, reduced exacerbations, improved quality of life and an increase...
Journal of Asthma and Allergy
Uncontrolled asthma in the elderly is a public health issue recognized in developed countries such as the United States and among the European Union, both from patient safety and economic perspectives. Variations in the cutoff, which defines elderly age, contribute to epidemiological study difficulties. Nonetheless, the relevance of elderly asthma from a socioeconomic perspective is inarguable. The projected growth of the enlarging geriatric population in the United States portends an impending national health burden that may or may not be preventable with pharmacologic and non-pharmacologic treatments. Asthma in the elderly might be a consequence of uncontrolled disease that is carried throughout a lifetime. Or elderly asthmatics could suffer from uncontrolled asthma, which overlaps with other ailments common with advancing ages that merit consideration, eg, COPD, heart disease, OSA, diabetes mellitus, and other comorbidities. Because of the heterogeneity of asthma phenotypes and other conditions that could mimic the symptoms of elderly asthma, further cohort studies are needed to elucidate the elderly asthmatic pathophysiology and management. More studies to characterize elderly asthma can help address these patients' unmet need for evidence-based guidelines. We introduce the 5 "Ps" (phenotypes, partnership, pharmacology, practice in acute exacerbations, and problems or barriers for the elderly asthmatics) that establish a framework approach for clinical practice.
Prevalence, morbidity and management of adult asthma in South Australia
Immunology and Cell Biology, 2001
This paper reviews asthma-related data obtained between 1987 and 1997 from self-report population surveys of adults in South Australia. A multistage, systematic, clustered area sample of adults (>15 years) was selected from a random sample of Australian Bureau of Statistics collector districts, and interviewed at home by trained health interviewers. The self-report prevalence of doctor-diagnosed asthma increased from 5.6% in 1987 to 12.2% in 1997. Morbidity measured as days lost from usual activities and nights awoken by asthma remained high, but hospitalization rates are trending down. The ownership of asthma action plans peaked in 1995 and has declined. The ownership of peak flow meters increased between 1992 and 1997, and the ownership of nebulisers remained constant. Evidence-based interventions are required to improve asthma management.
The American Journal of Medicine, 2009
At least 2 million US citizens over 65 years of age have asthma as a chronic disease, a number that will rapidly increase as the population ages. We used computer-assisted searches to identify epidemiologic studies specific for this age group published in the commonly available medical literature in English between 1988 and 2008. The prevalence of current asthma in individuals aged over 65 years is high (5.3%). Affected patients appear to perceive symptoms of asthma differently than younger patients, often have comorbid conditions with similar symptoms, and present for medical care later and with more fixed airways obstruction. Approximately 50% of deaths from asthma occur in the elderly, and mortality is increasing (10.5/100,000). We found only one longitudinal epidemiologic study that addressed the natural history of asthma in patients aged over 65 years, and that study used historical controls. Asthma in the elderly is a poorly studied, growing chronic disease that is underdiagnosed and undertreated. Present paradigms for diagnosis require modification.
The following questions will be addressed on older adults (>65) with asthma: 1. What are the psycho-social and/or health related experiences of living with asthma for older adults? 2. What 'inhibits' and/or 'enables' their asthma management? 3. What are their health and/or personal expectations? 4. What are their unsupported needs in asthma management? 5. How do the psycho-social and/or health related experiences and management of asthma of older adults compare with adults >18 years, but less than 65 years? 6. What are the key gaps in existing knowledge that future research should address? Searches Searches will be undertaken in the following electronic databases using free text or MeSH terms where applicable:
The Clinical Respiratory Journal, 2007
Introduction: Asthma mortality has declined overall because of a range of public health initiatives. In western countries, the majority of asthma deaths now occur in people over the age of 50. The reasons for the poorer response of older age groups to public health asthma initiatives are not known. Objectives: We undertook a study to investigate the disease perspectives of older people with asthma and barriers which may exist and prevent optimal asthma care. Methods: Fifty-five participants (16 male and 39 female) aged over 50 from an inner city, suburban area and a rural region were recruited. Lung function was measured, and questionnaire data on asthma symptoms, knowledge and control, medication use and respiratory health were collected. Participants were also interviewed in-depth, and the quantitative and qualitative data were triangulated. Results: Participants with a duration of asthma for >30 years reported significantly fewer symptoms and better quality of life irrespective of asthma severity, indicating less appreciation of symptoms in those with a long asthma duration. Interviews revealed this was related to previous asthma management strategies when treatment options were limited. Participants with a recent diagnosis sought understanding of asthma and the reason for their illness. Initiatives to improve asthma care in older people need to reflect these findings. Conclusions: Self-management strategies for older people need to be tailored according to the time of disease onset and the duration of disease.
Asthma in the elderly: a different disease?
Breathe, 2016
Key pointsAsthma in the elderly can be difficult to identify due to modifications of its clinical features and functional characteristics.Several comorbidities are associated with asthma in the elderly, and this association differs from that observed in younger patients.In clinical practice, physicians should treat comorbidities that are correlated with asthma (i.e. rhinitis or gastro-oesophageal reflux), assess comorbidities that may influence asthma outcomes (i.e. depression or cognitive impairment) and try to prevent comorbidities related to ‘drug-associated side-effects (i.e. cataracts, arrhythmias or osteoporosis).“Geriatric asthma” should be the preferred term because it implies the comprehensive and multidimensional approach to the disease in the older populations, whereas “asthma in the elderly” is only descriptive of the occurrence of the disease in this age range.Educational aimsTo present critical issues in performing differential diagnosis of asthma in the elderly.To of...
Challenges and Pitfalls in the Management of Geriatric Asthma
2023
Asthma is defined as a chronic airway disease that influences all ages, but does this definition too incorporate the elderly? Traditionally, asthma has been considered an illness of more youthful age, but epidemiological studies and clinical involvement support the concept that asthma is as prevalent in older age as it is within the youthful. According to the 2012 National Health Interview Survey Data, 208,500 people of age 65 and above develop asthma in a lifetime. This disease in the elderly has been critically misdiagnosed because usually old people think that shortness of breath is just a normal thing because of their old age. Asthma creates a much greater risk for older adults because they are more likely to develop respiratory failure as a result of the asthma, even during mild episodes of symptoms. The symptoms of asthma are as follows: chest tightness, shortness of breath, wheeze, and cough (especially at night). Many people aged 65 and older get their first asthma symptoms after an upper respiratory (chest) infection. The World Health Organization (WHO) has declared the coronavirus outbreak a global health emergency. Older people, with pre-existing medical conditions (such as asthma, diabetes, heart disease) appear to be more vulnerable to becoming severely ill with the virus. [1]