Better Outcomes at Lower Cost - American College of Allergy ...

symptoms and when to seek help for anasthma attack.Maintain disease control through a multifacetedapproach that includes prevention,appropriate use of medications and otherinterventions to prevent asthmasymptoms, and promote ongoing patienteducation and self-care strategiesThe most successful asthma control resultsfrom a partnership between patient andphysician. The allergist is uniquely qualified towork with patients to ensure proper use oflong-term controller medications, avoid overrelianceon quick-relief medications andprevent the hospitalizations, emergency roomvisits, days lost from work or school and otherdebilitating and expensive outcomes associatedwith poorly controlled asthma.Prevent serious consequences of asthmaFor persons who have required emergency careor hospitalization for asthma, care by anallergist can reduce the need for these acutecare services. Compared to care provided bygeneral medical professionals, the allergist ismore likely to educate the patient in selfmanagement,including the use of writtenasthma action plans and of peak flow metersto enhance asthma control.Aggressive Asthma Management:The Standard of CareUntil 1991, it was the consensus of physiciansthat asthma therapy should be conservativeand medications introduced one at a time, withdosage increases only when the conditionworsened. Contrasted to this are the currentevidence-based guidelines stipulating thatasthma should be diagnosed as early aspossible and treated aggressively while it is stillmild. Otherwise it may worsen and causepermanent scarring and irreversible remodelingof the lungs’ airways. [8]The disease should be treated with multiplemedications, if necessary, to control symptomsas soon as they appear. Allergists, with theirextensive experience using these medications,are able to prescribe them properly for theindividual patient. Aggressive therapy shouldbe initiated at the onset to establish immediatecontrol of symptoms. The therapy then may bestepped down as the patient’s conditionimproves. An allergy history, physical examand skin tests may be needed to identifyfactors triggering asthma exacerbations.Although the costs of the initial therapy maybe high, they are outweighed by significantlong-term health benefits and cost savings. [26]A study of medical treatments for 1,574patients enrolled in a managedcare plan found that the bestmanagers of asthma are specialistswho tend to be very aggressivewith diagnostics, therapies and theallocation of time to counsel thepatient. The study found that thecosts of care were about the sameor less than the care given bynonspecialists, and outcomes anddisease control were significantlyimproved for the patients treatedby specialists. [37]13