Best practices for pediatric asthma: improved clinical management for the inner-city patient.

Asthma patients who live in urban areas face many challenges that contribute to and influence poor outcomes. Many inner-city asthma patients are burdened with significant barriers to care, which include difficulty in obtaining short- and long-term treatment and misperceptions about the chronic nature of the disease. Poor access to care, poor quality of care, or both have been shown to contribute to the high morbidity rate in this population. The objective of asthma therapy is to interrupt allergen/antigen exposures wherever possible and to control airway inflammation. The goal of an effective asthma program is to prevent exacerbations of the disease, achieve and maintain normal activity levels and normal or near-normal lung function, and achieve a personal best for each patient with an effective action plan. An effective action plan is often difficult to implement because it takes much effort from both physician and patient to incorporate complete treatment strategies. Nevertheless, over time these plans can be very effective. The 1997 NIH report provides specific guidelines to help accomplish these goals.