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Många överbehandlas med astmamedicin

Stridh, Björn ; Romberg, Kerstin LU ; Ställberg, Björn ; Ahlbeck, Lars ; Kiotseridis, Hampus LU and Janson, Christer (2018) In Läkartidningen 115(13-14).
Abstract

Swedish asthma guidelines recommend treating asthma with the lowest effective dose possible. These recommendations are both hard to follow and seldom considered enough in asthma care today. As an example, combination therapy with inhaled corticosteroids (ICS) and long acting beta agonists (LABA) should only be considered if asthma control is not achieved with low to medium dose ICS daily. However, the Swedish National Board of Health and Welfare estimates that 120 000 asthma patients are overmedicated with combination therapy. Guidelines are clear in instructions of when and how to step up asthma treatment, while instructions for stepping down are not that obvious. In this article, we present an asthma treatment algorithm for step 1-3... (More)

Swedish asthma guidelines recommend treating asthma with the lowest effective dose possible. These recommendations are both hard to follow and seldom considered enough in asthma care today. As an example, combination therapy with inhaled corticosteroids (ICS) and long acting beta agonists (LABA) should only be considered if asthma control is not achieved with low to medium dose ICS daily. However, the Swedish National Board of Health and Welfare estimates that 120 000 asthma patients are overmedicated with combination therapy. Guidelines are clear in instructions of when and how to step up asthma treatment, while instructions for stepping down are not that obvious. In this article, we present an asthma treatment algorithm for step 1-3 in adults for use in clinical practice (Fig. 1), where stepping down asthma treatment is considered as an alternative. Included are also instructions of how to step down asthma treatment (Fig. 2). We conclude that stepping down is possible to do in a safe way in certain patient groups while maintaining asthma control. If possible risks are taken into consideration, stepping down asthma treatment can be done in every clinical setting.

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Please use this url to cite or link to this publication:
author
; ; ; ; and
organization
alternative title
When and how to step down asthma treatment
publishing date
type
Contribution to journal
publication status
published
subject
in
Läkartidningen
volume
115
issue
13-14
pages
1 pages
publisher
Swedish Medical Association
external identifiers
  • scopus:85044744941
ISSN
0023-7205
language
Swedish
LU publication?
yes
id
3e7dc035-ad19-414f-97a2-bb778608f95d
date added to LUP
2018-04-11 15:01:12
date last changed
2021-10-06 04:07:54
@article{3e7dc035-ad19-414f-97a2-bb778608f95d,
  abstract     = {<p>Swedish asthma guidelines recommend treating asthma with the lowest effective dose possible. These recommendations are both hard to follow and seldom considered enough in asthma care today. As an example, combination therapy with inhaled corticosteroids (ICS) and long acting beta agonists (LABA) should only be considered if asthma control is not achieved with low to medium dose ICS daily. However, the Swedish National Board of Health and Welfare estimates that 120 000 asthma patients are overmedicated with combination therapy. Guidelines are clear in instructions of when and how to step up asthma treatment, while instructions for stepping down are not that obvious. In this article, we present an asthma treatment algorithm for step 1-3 in adults for use in clinical practice (Fig. 1), where stepping down asthma treatment is considered as an alternative. Included are also instructions of how to step down asthma treatment (Fig. 2). We conclude that stepping down is possible to do in a safe way in certain patient groups while maintaining asthma control. If possible risks are taken into consideration, stepping down asthma treatment can be done in every clinical setting.</p>},
  author       = {Stridh, Björn and Romberg, Kerstin and Ställberg, Björn and Ahlbeck, Lars and Kiotseridis, Hampus and Janson, Christer},
  issn         = {0023-7205},
  language     = {swe},
  month        = {01},
  number       = {13-14},
  publisher    = {Swedish Medical Association},
  series       = {Läkartidningen},
  title        = {Många överbehandlas med astmamedicin},
  volume       = {115},
  year         = {2018},
}