Advancing asthma care: the glass is only half full!

Abstract

Over the past 20 years, there has been a concerted effort in the United States to reduce morbidity related to chronic disease, including asthma. Attention was initially directed toward asthma in response to the recognition that asthma mortality was increasing and that the burden of disease was significant. These efforts to address asthma mortality led to many new initiatives to develop clinical practice guidelines, implement the asthma guidelines into clinical practice, conduct research to fill the gaps in the guidelines, and continuously revise the asthma guidelines as more information became available. An assessment of our progress shows significant accomplishments in relation to reducing asthma mortality and hospitalizations. Consequently, we are now at a crossroads in asthma care. Although we have recognized some remarkable accomplishments in reducing asthma mortality and morbidity, the availability of new tools to monitor disease activity, including biomarkers and epigenetic markers, along with information technology systems to monitor asthma control hold some promise in identifying gaps in disease management. These advances should prompt the evolution of new strategies and new treatments to further reduce disease burden. It now becomes imperative to continue a focus on ways to further reduce the burden of asthma and prevent its onset.

Figure 1

Asthma prevalence in the United States, 1980–2009 Source: National Health Interview Survey; National Center for Health Statistics, Centers for Disease Control and Prevention

Figure 2

Figure 2a. Asthma hospitalizations per 10,000 population, United States, 1980–2008 Figure 2b. Asthma deaths per 100,000 population, United States 1981–2007 Source: National Hospital Discharge Survey, Mortality Component of the National Vital Statistics System; National Center for Health Statistics, Centers for Disease Control and Prevention Note: Asthma hospitalizations are first-listed using ICD-9CM code 493; Asthma deaths include those with underlying cause coded as ICD9 code 493 from 1981–1998, and ICD10 codes J45-J46 from 1999–2007.

Figure 3

Figure 3a. Asthma hospitalizations per 10,000 population, by race, United States, 1980–2008 Figure 3b. Asthma deaths per 100,000 population, by race, United States 1981–2007 Source: National Hospital Discharge Survey, Mortality Component of the National Vital Statistics System; National Center for Health Statistics, Centers for Disease Control and Prevention Note: Asthma hospitalizations are first-listed using ICD-9CM code 493; Asthma deaths include those with underlying cause coded as ICD9 code 493 from 1981–1998, and ICD10 codes J45-J46 from 1999–2007.

Figure 4

Figure 4a. Asthma hospitalizations per 10,000 population, by sex, United States, 1980–2008 Figure 4b. Asthma deaths per 100,000 population, by sex, United States 1981–2007 Source: National Hospital Discharge Survey, Mortality Component of the National Vital Statistics System; National Center for Health Statistics, Centers for Disease Control and Prevention Note: Asthma hospitalizations are first-listed using ICD-9CM code 493; Asthma deaths include those with underlying cause coded as ICD9 code 493 from 1981–1998, and ICD10 codes J45-J46 from 1999–2007.