The burden of asthma and improving patient outcomes.

Asthma is a significant national burden owing to patient morbidity and mortality, rising healthcare costs, and employee absenteeism. The National Asthma Education and Prevention Program (NAEPP) guidelines were created to improve the diagnosis and treatment of asthma, and stress 4 central components for the management of asthma: (1) measures of assessment and monitoring (obtained by patient history and patient reports; physical examinations and objective tests to confirm, diagnose, and assess severity of asthma initially, and to monitor asthma control subsequently); (2) education for a partnership in asthma care; (3) a focus on control of environmental factors and comorbid conditions that affect asthma; and (4) evidence-based decision making about pharmacologic therapy. The NAEPP guidelines recommend step-up and step-down programs for pharmacologic therapy. There are several barriers to effective asthma control. Treatment adherence in patients with asthma is suboptimal. Moreover, clinicians may not completely adhere to treatment guidelines. Finally, insurance companies may indirectly contribute to poor guideline adherence by failing to adequately recognize the time required to educate patients on asthma and develop a partnership for success, as requested by the guidelines. Successful asthma management requires effort by all parties involved, with the ultimate goal of improved outcomes, including reduced medical complications and costs.