Correia-DE-Sousa Jaime, Vicente Cláudia, Brito Dinis, Tsiligianni Ioanna, Kocks Janwillem W, Román-Rodriguez Miguel, Baxter Noel, Maricoto Tiago, Williams Siân
ICVS/3B's Associate Laboratory, Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal -
Araceti Family Health Unit, Coimbra, Portugal.
Minerva Med. 2021 Oct;112(5):582-604. doi: 10.23736/S0026-4806.21.07277-3.
Asthma brings considerable challenges for family doctors because of its variety of shapes, different levels of severity, a wide age range, and the fact that in the last decades clinicians are able to offer much better treatment options with a better level of disease control and a higher quality of life. The objectives of the current review article are to provide an up-to-date review by primary care respiratory leaders from different countries of the most significant challenges regarding asthma diagnosis and management, the importance of team work and the problems in recognizing and dealing with difficult-to-manage and severe asthma in primary care. The article provides a short review of the main challenges faced by family physicians and other primary health care professionals in supporting their patients in the management of asthma, such as asthma diagnosis, promoting access to spirometry, the importance of a multiprofessional team for the management of asthma, how to organize an asthma review, the promotion of patient autonomy and shared decision-making, improving the use of inhalers, the importance of the personalized asthma action plan, dealing with difficult-to-manage and severe asthma in primary care and choosing when, where and how to refer patients with severe asthma. The article also discusses the development of an integrated approach to asthma care in the community and the promotion of Asthma Right Care.
哮喘给家庭医生带来了相当大的挑战，这是因为其表现形式多样、严重程度不同、发病年龄范围广泛，而且在过去几十年里，临床医生能够提供更好的治疗选择，实现更好的疾病控制水平和更高的生活质量。本综述文章的目的是，由来自不同国家的基层医疗呼吸领域的专家，对哮喘诊断和管理方面最重要的挑战、团队合作的重要性以及基层医疗中识别和处理难治性及重度哮喘的问题进行最新综述。本文简要回顾了家庭医生和其他初级卫生保健专业人员在支持患者管理哮喘时面临的主要挑战，例如哮喘诊断、促进肺功能测定的可及性、多专业团队对哮喘管理的重要性、如何组织哮喘复查、促进患者自主性和共同决策、改善吸入器的使用、个性化哮喘行动计划的重要性、在基层医疗中处理难治性及重度哮喘以及选择何时、何地以及如何转诊重度哮喘患者。本文还讨论了社区哮喘综合护理方法的发展以及促进哮喘正确护理。
