Aims of treatment for people with asthma
Asthma is a chronic disease characterised by the presence of widespread,
variable airflow obstruction and accompanied by respiratory symptoms. An
important aim of treatment is to improve quality of life by ameliorating the
severity of symptoms both on a day-to-day basis and during severe exacerbations.
In part, this is achieved by treating these episodes when they arise. However,
it is most effectively achieved by preventing the onset of symptoms, and of
severe exacerbations, and this can be achieved with good control of the
underlying disease abnormality.
Symptoms arise in people with asthma due to airway narrowing. Hence,
prevention and reversal of airway narrowing are also important aims of therapy.
Asthma may have long-term adverse consequences including premature, irreversible
loss of lung function and premature death. The prevention of these outcomes is
an important aim of treatment. Effective management of people with asthma
entails achieving these aims with the minimum amount of medications. The level
of treatment required to achieve good asthma control is another indicator of the
severity of the disease or of the effect of alternative management strategies.
The maintenance of quality of life through effective management is also a key
aim of treatment. For the person with asthma, the goal is to improve and then
maintain the capacity to perform everyday activities – to not be limited by
asthma.
The National Asthma Council’s Asthma Management Handbook 2002 (available at
www.nationalasthma.org.au) makes recommendations for the assessment and
management of asthma in order to achieve these aims. This is a useful resource
recommended for all health professionals caring for people with asthma.
In considering the role of complementary therapies in the management of
asthma, and in advising patients about their possible use, it is the
responsibility of the health professional to be aware of the impact of treatment
on both short-term and long-term outcomes of the illness. For example, evidence
of short-term efficacy for relief of symptoms or reversal of bronchoconstriction
may not be sufficient for recommending a therapy for people with asthma, as
there is evidence that long-term undertreatment of asthma can lead to long-term
adverse health effects.
In this review, the effects of complementary therapies are summarised in
terms of their effects on the following clinically relevant outcomes of asthma:
- symptoms and quality of life
- lung function
- medication requirement.
Exacerbations, premature death and loss of lung function are seldom measured in
clinical trials of complementary therapies and are not considered in this
review.
