Die Asthmakontrolle bei Erwachsenen und Kindern muss optimiert werden!

Zusammenfassung

Entsprechend der GINA-Kriterien ist es Ziel des Asthma-Managements, eine optimale Symptomkontrolle zu erreichen und die Risiken für Exazerbationen, Verschlechterungen der Lungenfunktion, Langzeitfolgen und Nebenwirkungen der Therapie zu minimieren. Studien wie REALISE und AIRE geben uns Informationen dahingehend, ob und wie sich innerhalb von annähernd 15 Jahren Verbesserungen bei der Versorgung von Patienten mit Asthma bronchiale eingestellt haben. Obwohl es sehr wirksame Medikamente zur Behandlung des Asthma bronchiale gibt, sind die Ergebnisse der Asthmakontrolle weiterhin unbefriedigend. Bei deutlich mehr als 50 % der Patienten muss das Asthma als nicht bzw. schlecht kontrolliert angesehen werden. Eine schlechte Therapieadhärenz, die Angst vor systemischen Effekten der inhalativen Kortisontherapie, die vermehrte Inanspruchnahme der Bedarfstherapie, eine nicht ausreichende Schulung und Aufklärung der Patienten sind dafür verantwortlich. Es besteht eine Notwendigkeit zur Intensivierung der Schulungsmaßnahmen und verbesserten Patientenüberwachung.

Abstract

Medication management of asthma is based on level of asthma control. GINA defined criteria for asthma control include asking about daytime symptoms, limitation of activity, nocturnal symptoms/awakenings and need for reliever treatment. Effective asthma control is necessary for preventing exacerbations and worsening of lung function. Standardized and validated questionnaires such as asthma control test (ACT) help to assess the level of asthma control. Asthma control is classified as controlled, partially controlled or uncontrolled. Multicenter studies like REALISE and AIRE give health care professionals information about effectiveness and adherence to medication over nearly 15 years. Asthma is still poorly controlled in more than 50 % of patients despite the availability of very effective drugs. Low adherence to the treatment, fear of systemic side effects related to long term treatment with inhaled corticosteroids, inadequate knowledge of the disease may be responsible factors for bad asthma control. Optimized tools for disease management and intensified education are necessary for therapeutic success.

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