Télécharger le supplément (250 p.) - KCE

KCE Reports 85 S Médecine à l’acte/médecine au forfait – ANNEXES 33
Patients with asthma over the age of 10 should have been given smoking advice
(2,3)
Smokers should be advised how to stop using a combination of advice and
support form a health professional (2,3)
For patients on current medication or presenting with asthma, patients should be
asked at every asthma consultation in the last year about: any difficulty
sleeping due to asthma – any asthma symptoms during the day i.e. cough,
wheeze – whether asthma has interfered with usual daily activities (2,3)
In acute situations requiring emergency treatment the following should be
assessed and recorded: - pulse rate – respiratory rate (2,3)
Patients with an exacerbation should be treated with oral corticosteroids by the
GP, unless contraindicated or intolerant, if their PEF is < 50% of normal /
predicted unless they are admitted to hospital (2,3)
Patients should be referred to a specialist if they have occupational asthma (2,3)
Management of acute attacks: (nebulised bronchodilatators: pour un auteur ces
bronchodilatateurs en + des 2 autres tts) – systemic steroids – “step-up” in
preventative therapy (8)
The record show that patients experiencing daytime symptoms more frequently
than 6 days a week have been offered an inhaled anti-inflammatory drug (9)
Exemple: The record shows that in exacerbation of asthma when the peak flow
has fallen to less than 60% ... a short acting ... (9)
Annual review (target standard= 100%) (7)
≥ 70% asthma patients reviewed in the last 12 months (10)
The percentage of patients with asthma who have had an asthma review in the
last 15 months (36)
mal définis par auteurs:
Assessment of asthma severity (8)
Regular preventive treatment(8)
What to do in an emergency/action plan(8)
Inhaled steroids(8)
Trigger factor avoidance (8)
Appropriate asthma medication regimes (8)
Inappropriate asthma medication regimes :other (8)
Performance indicator: asthma prophylaxis / bronchodilatators prescribing ratio
(33)
Patients using short-acting β2 agonists > 1 time a day should be offered
prophylactic medication tailored to their individual needs (2,3)
Appropriate use of prophylactic treatment (target standard: 100% in those
patients with at least moderate asthma) (7)
nécessitent données cliniques ou d’enregistrement dans les dossiers:
Where there is evidence form the notes that symptoms are not controlled using
β agonists and low dose inhaled steroids, a trial of long acting
bronchodilatator or high dose inhaled steroids is offered (9)