Advances in adult asthma diagnosis and treatment and health outcomes, education, delivery, and quality in 2008

Received 18 November 2008; accepted 19 November 2008.

In 2008 the Journal reported new findings in management of asthma. Dosing schedules of inhaled steroids have been modified and individualized. New, more costly propellants are replacing ozone-depleting chlorofluorocarbons. An association of asthma with pneumococcal disease has been observed. Smoking bans in public places are eliminating second-hand smoke and reducing asthma-related emergency department visits among adults. In contrast with these advances, however, disparity in asthma morbidity persists: black persons compared with white persons have a 4-fold greater risk of an asthma-related emergency department visit.

Key words: Asthma, adults, genetics, inhaled corticosteroids, exhaled breath condensate, nitric oxide, chlorofluorocarbon, short-acting β-agonists, health literacy

Abbreviations used: AERD, Aspirin-exacerbated respiratory disease, EBC, Exhaled breath condensate, ED, Emergency department, EPR, National Asthma Education and Prevention Program Expert Panel Report, FeNO, Fraction of exhaled nitric oxide, ICS, Inhaled corticosteroid, IVR, Interactive voice-response, SABA, Short-acting β2-agonist

Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Pennsylvania, Philadelphia, Pa

Reprint requests: Andrea J. Apter, MD, MSc, 829 Gates Building, Hospital of the University of Pennsylvania, 3600 Spruce Street, Philadelphia, PA 19104.

Supported by the National Heart, Lung, and Blood Institute (HL073932, HL088469).

Disclosure of potential conflict of interest: A. Apter has received grant support from the National Heart, Lung, and Blood Institute.

PII: S0091-6749(08)02209-4

doi:10.1016/j.jaci.2008.11.017

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