The results of these studies suggest that effective clinical and public health strategies are needed to prevent and manage asthma in the Canadian population.Īsthma is associated with T helper cell type-2 (Th2) immune responses, which are typical of other atopic conditions. Compared with females, males experienced higher increases in prevalence in adolescence and young adulthood and lower increases at age 70 years or older.Īnother recent study of over 2800 school-aged children in Toronto that assessed parental reports of asthma by questionnaire found the prevalence of asthma to be approximately 16% in this young population. The age-standardized increase in prevalence was greatest in adolescents and young adults compared with other age groups, and the gender-standardized increase in prevalence was greater in males compared with females. A population-based cohort study conducted in Ontario found that the age- and sex-standardized asthma prevalence increased from 8.5% in 1996 to 13.3% in 2005, a relative increase of 55%. More recent epidemiological evidence suggests that that the prevalence of asthma in Canada is rising, particularly in the young population. Seven of these deaths occurred in persons under 19 years of age, while the majority (62%) occurred in those over 70 years of age. In 2001, a total of 299 deaths were attributed to asthma. However, the survey also found that mortality due to asthma has fallen sharply since 1985. Between 19, close to 80,000 Canadians were admitted to hospital for asthma, and hospitalization rates were highest among young children and seniors. The 2003 Canadian Community Health Survey found that 8.4% of the Canadian population ≥ 12 years of age had been diagnosed with asthma, with the prevalence being highest among teens (> 12%). This article provides an overview of diagnostic and therapeutic guideline recommendations from the Global Initiative for Asthma (GINA) and the Canadian Thoracic Society and as well as a review of current literature related to the pathophysiology, diagnosis, and appropriate treatment of asthma. Poor asthma control contributes to unnecessary morbidity, limitations to daily activities and impairments in overall quality of life. Results from the Reality of Asthma Control in Canada study suggest that over 50% of Canadians with asthma have uncontrolled disease.
ĭespite significant improvements in the diagnosis and management of asthma over the past decade, as well as the availability of comprehensive and widely-accepted national and international clinical practice guidelines for the disease, asthma control in Canada remains suboptimal. Although asthma is often believed to be a disorder localized to the lungs, current evidence indicates that it may represent a component of systemic airway disease involving the entire respiratory tract, and this is supported by the fact that asthma frequently coexists with other atopic disorders, particularly allergic rhinitis. It is also the most common chronic disease of childhood. This article provides a review of current literature and guidelines for the appropriate diagnosis and management of asthma in adults and children.Īsthma remains the most common chronic respiratory disease in Canada, affecting approximately 10% of the population. In addition to avoidance measures and pharmacotherapy, essential components of asthma management include: regular monitoring of asthma control using objective testing measures such as spirometry, whenever feasible creation of written asthma action plans assessing barriers to treatment and adherence to therapy and reviewing inhaler device technique. Allergen-specific immunotherapy represents a potentially disease-modifying therapy for many patients with asthma, but should only be prescribed by physicians with appropriate training in allergy. Biologic therapies targeting immunoglobulin E or interleukin-5 are recent additions to the asthma treatment armamentarium and may be useful in select cases of difficult to control asthma. Combination ICS/long-acting beta 2-agonist inhalers are preferred for most adults who fail to achieve control with ICS therapy.
Inhaled corticosteroids (ICS) represent the standard of care for the majority of patients. In most patients, however, control can be achieved through the use of avoidance measures and appropriate pharmacological interventions. Despite significant improvement in the diagnosis and management of this disorder, the majority of Canadians with asthma remain poorly controlled. Asthma is the most common respiratory disorder in Canada.
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