Feature Articles: Asthma

Asthma is a chronic inflammatory disease of the airway. In the United States, asthma affects fifteen to sixteen million persons and is the most common chronic disease of childhood, affecting an estimated five million children. The tremendous impact of this disease is reflected by the fact that people with asthma have collectively more than one hundred million days of restricted activity, five hundred thousand hospitalizations annually. More than five thousand people die of asthma annually. In addition, both the prevalence and hospitalization rates of asthma is increasing for reasons that are poorly understood. Altogether, asthma in children is responsible for an estimated ten million lost school days, two hundred thousand hospitalizations, and five hundred million dollars in direct medical expenses per year.

As the burden of illness has increased, many of the aspects of management. An appreciation of the central role of inflammation in the pathogenesis of asthma has resulted in newer anti-inflammatory medications. In addition, appreciation of the physiology of b-agonists has also led to a more rational use of bronchodilator therapy. The social and economic implications of the disease however, should also be considered in overall management. These factors assume greater significance since changes in healthcare delivery may limit access to routine care, a factor known to influence the outcome of this disease.

While this monograph is not intended to be exhaustive, we hope it will highlight certain aspects of asthma management, raise awareness of the importance of a proper coordinated approach to treatment, and provide suggested readings for those who crave more detailed information.