scholarly journals Asthma knowledge, care, and outcome during pregnancy: The QAKCOP study

2018 ◽  
Vol 16 ◽  
pp. 147997231876771 ◽  
Author(s):  
Wanis H Ibrahim ◽  
Fatima Rasul ◽  
Mushtaq Ahmad ◽  
Abeer S Bajwa ◽  
Laith I Alamlih ◽  
...  
Keyword(s):  
Health Care ◽  
Asthma Control ◽  
Inhaled Corticosteroids ◽  
Medical Condition ◽  
Action Plan ◽  
Well Being ◽  
Chronic Medical Condition ◽  
Uncontrolled Asthma ◽  
Asthma Care ◽  
In Pregnancy

Asthma is the most common chronic medical condition affecting pregnancy. Optimizing asthma management in pregnancy is paramount for the well-being of both the mother and the baby. The primary objectives of this study were to assess patient’s knowledge about asthma, the level of asthma care, and fetal and maternal outcomes among pregnant asthmatic women in this wealthy country with tremendous improvement in maternal and fetal health care. The secondary objective was to identify barriers to asthma control. This was a cross-sectional, face-to-face, prospective study of 80 pregnant women with physician-diagnosed asthma. About 56% of patients reported worsening of their asthma control during pregnancy, of which 52.3% felt this worsening in the third trimester. About 65% of patients had uncontrolled asthma during their pregnancy, and inhaler technique was incorrect in 64.4%. Only 38% of patients knew the difference between controller and reliever asthma medications, 12.7% of patients had received written asthma action plan, 17% had a spirometry done in the previous 5 years, and 3.8% had peak expiratory flow meter at home. The main reasons for uncontrolled asthma were lack of knowledge about right asthma medications in 30% and fear of side effects of inhaled corticosteroids in 19% of patients. No financial reason was reported. Significant associations between total number of pregnancies, poor perception of asthma medications, asthma exacerbation during delivery and poor asthma control were observed. Preeclampsia and congenital anomalies occurred at higher rates than previously reported among general population in this country. The tremendous improvements in maternal health care and socioeconomic status do not seem to be a barrier to the globally recognized poor asthma care in pregnancy. Important strategies are much needed.

Pregnancy

Asthma ◽  
2014 ◽  
pp. 367-376
Author(s):  
Jennifer A. Namazy ◽  
Michael Schatz ◽  
Sandra Gonzalez-Diaz
Keyword(s):  
Inhaled Corticosteroids ◽  
Medical Condition ◽  
Action Plan ◽  
Safety Information ◽  
Asthma Management ◽  
Perinatal Outcomes ◽  
Chronic Medical Condition ◽  
Monthly Basis ◽  
Maternal Quality Of Life ◽  
Therapy Education

Asthma is the most common chronic medical condition to affect pregnancy. Asthma may adversely affect maternal quality of life and perinatal outcomes, as well as the course of asthma. Management of asthma during pregnancy should optimize the health of both the mother and her baby. Adherence to treatment, specifically inhaled corticosteroids, has been a problem for many pregnant asthmatic women and is usually due to concerns regarding the safety of these medications during pregnancy. Symptoms and pulmonary function need to be monitored on a monthly basis in pregnant asthmatic women so that any change in course can be matched with an appropriate change in therapy. Education is an important part of managing the pregnant asthmatic patient and includes explaining the relationship between asthma and pregnancy, identifying asthma triggers, providing training on correct use of inhalers, and establishing an asthma action plan. One of the most important needs for the future is the availability of further safety information for asthma medications used during pregnancy that can also account for asthma control.

scholarly journals Managing asthma in pregnancy

Breathe ◽  
2015 ◽  
Vol 11 (4) ◽  
pp. 258-267 ◽  
Author(s):  
Vanessa E. Murphy
Keyword(s):  
Pregnant Women ◽  
Inhaled Corticosteroids ◽  
Action Plan ◽  
Asthma Management ◽  
Perinatal Outcomes ◽  
List Type ◽  
Night Time ◽  
Exacerbation Rate ◽  
Common Chronic Disease ◽  
In Pregnancy

Asthma is a common comorbidity during pregnancy and its prevalence is increasing in the community. Exacerbations are a major clinical problem during pregnancy with up to 45% of women needing to seek medical help, resulting in poor outcomes for mothers and their babies, including low birth weight and preterm delivery. The goals of effective asthma management in pregnancy are to maintain the best possible asthma control and prevent exacerbations. This is achieved by aiming to prevent day- and night-time symptoms, and maintain lung function and normal activity. In addition, maintaining fetal oxygenation is an important consideration in pregnancy. Guidelines recommend providing asthma advice and review prior to conception, and managing asthma actively during pregnancy, with regular 4-weekly review, provision of a written action plan, use of preventer medications as indicated for other adults with asthma, and management of comorbid conditions such as rhinitis.Improvements have been made in recent years in emergency department management of asthma in pregnancy, and multidisciplinary approaches are being proposed to optimise both asthma outcomes and perinatal outcomes. One strategy that has demonstrated success in reducing exacerbations in pregnancy is treatment adjustment using a marker of eosinophilic lung inflammation, the exhaled nitric oxide fraction (FeNO). The use of an algorithm that adjusted inhaled corticosteroids (ICS) according toFeNOand added long-acting β-agonists when symptoms remained uncontrolled resulted in fewer exacerbations, more women on ICS but at lower mean doses, and improved infant respiratory health at 12 months of age. Further evidence is needed to determine whether this strategy can also improve perinatal outcomes and be successfully translated into clinical practice.Key pointsAsthma is the most common chronic disease to affect pregnant women.Exacerbations occur in up to 45% of pregnant women with asthma.Asthma should be managed during pregnancy as for other adults.Treatment adjustment using a marker of airway inflammation reduces the exacerbation rate in pregnancy.Educational aimsTo identify the goals of and steps associated with effective asthma management in pregnancy.To understand the maternal and perinatal risks associated with asthma during pregnancy.To describe a management strategy that has been shown to reduce exacerbations in pregnant women with asthma.

scholarly journals Reduced health-care utilization among people with chronic medical conditions during coronavirus disease 2019

2020 ◽  
pp. 201010582096453
Author(s):  
Chetna Malhotra ◽  
Isha Chaudhry ◽  
Semra Ozdemir ◽  
Eric Andrew Finkelstein
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Perceived Risk ◽  
Risk Perceptions ◽  
Medical Condition ◽  
Chronic Medical Condition ◽  
Care Utilization ◽  
Chronic Medical Conditions ◽  
Medical Conditions ◽  
Care Appointment

The coronavirus disease 2019 (COVID-19) outbreak may impact the health-care-seeking behaviour of people with pre-existing chronic medical conditions. We aimed to assess the extent, reasons and correlates of reduced health-care utilization among people with chronic medical conditions in Singapore during the COVID-19 pandemic. We administered a web-survey to a panel of residents between 31 March and 14 April 2020. We assessed the proportion of participants with self-reported chronic conditions that missed their health-care appointment during the outbreak either voluntarily (demand driven) or because it was cancelled by their provider (supply driven). We performed a logistic regression to examine the association of voluntarily missing the health-care appointment with participants’ age and risk perceptions. Of the 1017 surveyed participants, 349 reported at least one chronic medical condition. Of these, 40% reported missing their health-care appointment during the COVID-19 outbreak. Of these, 72% did so voluntarily, and 39% reported that it was cancelled by their provider. Younger participants, those with a greater worry of contracting COVID-19 and those with a higher perceived risk of dying due to COVID-19 were more likely to miss their health-care appointments voluntarily. These results highlight the need to ensure continuity of care for people with chronic medical conditions in order to avoid the long-term impact on their health and mortality.

scholarly journals Towards Excellence in Asthma Management: Final Report of an Eight-Year Program Aimed at Reducing Care Gaps in Asthma Management in Quebec

2008 ◽  
Vol 15 (6) ◽  
pp. 302-310 ◽  
Author(s):  
Louis-Philippe Boulet ◽  
Eileen Dorval ◽  
Manon Labrecque ◽  
Michel Turgeon ◽  
Terrence Montague ◽  
...  
Keyword(s):  
Health Care ◽  
Disease Management ◽  
Health Care System ◽  
Inhaled Corticosteroids ◽  
Asthma Management ◽  
Final Report ◽  
Asthma Care ◽  
Treatment Needs ◽  
Care Gaps ◽  
Care System

BACKGROUND AND OBJECTIVES: Asthma care in Canada and around the world persistently falls short of optimal treatment. To optimize care, a systematic approach to identifying such shortfalls or ‘care gaps’, in which all stakeholders of the health care system (including patients) are involved, was proposed.METHODS: Several projects of a multipartner, multidisciplinary disease management program, developed to optimize asthma care in Quebec, was conducted in a period of eight years. First, two population maps were produced to identify regional variations in asthma-related morbidity and to prioritize interventions for improving treatment. Second, current care was evaluated in a physician-patient cohort, confirming the many care gaps in asthma management. Third, two series of peer-reviewed outcome studies, targeting high-risk populations and specific asthma care gaps, were conducted. Finally, a process to integrate the best interventions into the health care system and an agenda for further research on optimal asthma management were proposed.RESULTS: Key observations from these studies included the identification of specific patterns of noncompliance in using inhaled corticosteroids, the failure of increased access to spirometry in asthma education centres to increase the number of education referrals, the transient improvement in educational abilities of nurses involved with an asthma hotline telephone service, and the beneficial effects of practice tools aimed at facilitating the assessment of asthma control and treatment needs by general practitioners.CONCLUSIONS: Disease management programs such as Towards Excellence in Asthma Management can provide valuable information on optimal strategies for improving treatment of asthma and other chronic diseases by identifying care gaps, improving guidelines implementation and optimizing care.

scholarly journals Body mass index, waist-hip ratio and risk of chronic medical condition in the elderly population: results from the Well-being of the Singapore Elderly (WiSE) Study

2016 ◽  
Vol 16 (1) ◽  
Author(s):  
Restria Fauziana ◽  
Anitha Jeyagurunathan ◽  
Edimansyah Abdin ◽  
Janhavi Vaingankar ◽  
Vathsala Sagayadevan ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Elderly Population ◽  
Medical Condition ◽  
Well Being ◽  
The Elderly ◽  
Chronic Medical Condition ◽  
Waist Hip Ratio

scholarly journals Current trends in drugs avoided in pregnancy

2018 ◽  
Vol 8 (6) ◽  
pp. 342-350
Author(s):  
Bathala Anitha ◽  
S Malavika ◽  
B Kumar ◽  
Yerikala Ramesh
Keyword(s):  
Health Care ◽  
Medical Treatment ◽  
Health Care Professionals ◽  
Classical Problem ◽  
Well Being ◽  
Unborn Child ◽  
Medical Conditions ◽  
Episodic Treatment ◽  
Current Trends ◽  
In Pregnancy

During pregnancy several drugs are having contraindication, hence their use is less and dangerous to mother along with fetus .Drugs play an important role in improving the health and promoting well-being. However to produce desired effect, they have to be safe, efficacious and have to be used rationally. During pregnancy medication is less preferred but in some times cannot be escaped to treat the ailments in mother. Avoiding medications may be desirable, it is often not possible and may be dangerous because some women enter pregnancy medical conditions that require continuous and episodic treatment (e.g. asthma, hypertension, epilepsy). So here we discussed the medication that can be used safely during pregnancy along with unsafe and highly contraindicated for both mother and fetus. Certain drugs given during pregnancy may prove harmful to unborn child is one of the classical problem in the medical treatment. The main purpose of this review is to prepare a list of safe medications which can be taken during pregnancy with unsafe and highly contraindicated drugs. And also a quick reference for health care professionals. Keyboard: Current, Pregnancy, Drugs, Fetus

Why Supplemental Security Income Is Important for Children and Adolescents

PEDIATRICS ◽  
1995 ◽  
Vol 95 (4) ◽  
pp. 603-608
Author(s):  
Keyword(s):  
Health Care ◽  
Special Needs ◽  
Low Income ◽  
Health Care Services ◽  
Family Income ◽  
Medical Condition ◽  
Supplemental Security Income ◽  
Chronic Medical Condition ◽  
Social Security Administration ◽  
Care Needs

The Supplemental Security Income (SSI) program for children is an important part of the federal government's social benefits program for children with special needs. The SSI program is a nationwide program administered by the Social Security Administration (SSA) that does the following: • provides monthly cash payments based on family income, • qualifies the child for Medicaid health care services in many states, and • assures referral of SSI child beneficiaries into the state Title V Children With Special Health Care Needs program's system of care. The SSA considers a child to be disabled if: • the impairment-physical or mental, or chronic medical condition-is as severe as a condition that would keep an adult from working, • the condition is expected to last a long time or is life threatening, and • the child is unable to engage in the everyday activities that most children the same age can do. Congress implemented the children's component of the SSI program in 1974 in recognition that disabled children who live in low-income households are among the most disadvantaged of all Americans and therefore deserve special assistance. The cost of caring for a child with special needs is an especially heavy burden for families with limited resources. The intent of the SSI program is to reduce the additional deleterious environmental effects that a low family income can have on the growth and development of the disabled child and thereby help these children become self-supporting members of society. The SSI program provides cash benefits.

Asthma in pregnancy

1994 ◽  
Vol 6 (4) ◽  
pp. 181-189 ◽  
Author(s):  
Catherine Nelson-Piercy ◽  
Michael de Swiet
Keyword(s):  
Air Pollution ◽  
Young Adults ◽  
House Dust Mite ◽  
Medical Condition ◽  
Chronic Medical Condition ◽  
Childhood Exposure ◽  
Apparent Increase ◽  
Child Bearing ◽  
Dust Mite ◽  
In Pregnancy

Asthma is the most common significant chronic medical condition affecting young adults and it is therefore often encountered in pregnancy. Approximately 3% of women of child-bearing age suffer some degree of asthma and this prevalence is increasing. Some of the apparent increase is due to heightened awareness of the condition, although air pollution and increased childhood exposure to house dust mite may also be contributing.

Sign in / Sign up

Export Citation Format

Share Document