Warraich Sara, Sonnappa Samatha
Department of Respiratory Pediatrics, Royal Brompton Hospital, London, United Kingdom.
Front Pediatr. 2022 Jul 7;10:930196. doi: 10.3389/fped.2022.930196. eCollection 2022.
Asthma remains the most prevalent chronic respiratory disease of childhood. Severe asthma accounts for a minority group of patients but with substantial morbidity burden. It may reflect disease which is resistant to treatment or that which is difficult to treat, or a combination of both. The adolescent patient cohort denote a unique group and are the focus of this review. This group of patients embody transitioning priorities and evolving health beliefs, all of which may influence the management and burden of disease. Factors of importance include the influence of physiological parameters such as sex and race, which have confer implications for medical management and non-physiological factors, such as adherence, risk-taking behavior, and vaping. The holistic approach to management of severe asthma within this group of patients must acknowledge the evolving patient independence and desire for autonomy and strive for a collaborative, patient tailored approach. This review will focus on the factors that may pose a challenge to the management of severe adolescent asthma whilst offering suggestions for changes in practice that might harness patient priorities and shared clinical decision-making.
哮喘仍然是儿童期最常见的慢性呼吸道疾病。重度哮喘患者占少数，但疾病负担却相当大。这可能反映出对治疗有抵抗性或难以治疗的疾病，或两者兼而有之。青少年患者群体是一个独特的群体，也是本综述的重点。这群患者体现了不断变化的优先事项和不断演变的健康观念，所有这些都可能影响疾病的管理和负担。重要因素包括生理参数（如性别和种族）的影响，这对医疗管理有一定影响，以及非生理因素，如依从性、冒险行为和吸电子烟。对这群患者的重度哮喘进行整体管理时，必须认识到患者日益增强的独立性和对自主权的渴望，并努力采取一种协作性的、针对患者的方法。本综述将重点关注可能对重度青少年哮喘管理构成挑战的因素，同时为实践中的改变提供建议，这些改变可能会利用患者的优先事项并促进共同的临床决策。
