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Living well with severe asthma

Michelle A. Stubbs, Vanessa L. Clark, Vanessa M. McDonald
Breathe 2019 15: e40-e49; DOI: 10.1183/20734735.0165-2019
Michelle A. Stubbs
1Priority Research Centre for Healthy Lungs and Centre of Excellence in Severe Asthma, Faculty of Health and Medicine, The University of Newcastle, New Lambton Heights, Australia
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Vanessa L. Clark
1Priority Research Centre for Healthy Lungs and Centre of Excellence in Severe Asthma, Faculty of Health and Medicine, The University of Newcastle, New Lambton Heights, Australia
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Vanessa M. McDonald
1Priority Research Centre for Healthy Lungs and Centre of Excellence in Severe Asthma, Faculty of Health and Medicine, The University of Newcastle, New Lambton Heights, Australia
2Dept of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, Australia
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  • For correspondence: vanessa.mcdonald@newcastle.edu.au
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    Figure 1

    Symptoms, impacts, areas of burden and treatment options for people living with severe asthma.

Tables

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  • Table 1

    Common comorbidities associated with severe asthma

    Pulmonary and upper airwaysExtrapulmonary
    Allergic and nonallergic rhinitisObesity
    Chronic rhinosinusitisAnxiety and depression
    Dysfunctional breathingGastro-oesophageal reflux disease
    Vocal cord dysfunctionOsteoporosis
    Chronic obstructive pulmonary diseaseCardiovascular disease
    BronchiectasisMetabolic disease
    Obstructive sleep apnoea

    Reproduced and modified from [15] with permission.

    • Table 2

      Summary of severe asthma burden domains, characteristics, impacts and nonpharmacological strategies

      BurdenCharacteristicImpactStrategy
      EmotionalFeeling alonePersonal relationshipsEducation sessions
      GuiltEveryday activities/rolesPsychotherapeutic intervention
      Anxiety and/or depressionPhysical activityExercise intervention
      PanicTreatment adherenceMultidimensional assessment
      FinancialWorsening of symptomsHealthcare servicesWritten asthma action plan
      Poor treatment adherenceInability to purchase medicationsSymptom monitoring
      Loss of productivity at workCareer choice/longevityPsychotherapeutic intervention
      AbsenteeismEmploymentPsychosocial and family support
      FunctionalFatigueEmployment/social engagementsMultidimensional assessment
      Inability to participate in desired activities/lifestyleRelationships/travelEducation sessions
      Decrease in moderate and vigorous physical activityWeight gain/obesity/deconditioningExercise interventions
      Lack of personal and emotional intimacyPersonal relationshipsPsychotherapeutic intervention
      MedicationNonadherenceSymptom controlMultidimensional assessment
      ComorbiditiesDisease management complexityAssessment and guideline-based treatment
      Neuropsychiatric symptomsTreatment adherenceWritten asthma action plan
      Lack of intimacyPersonal relationshipsPsychotherapeutic intervention
      Weight gainPhysical activity/self-esteemExercise intervention
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    Vol 15 Issue 2 Table of Contents
    Breathe: 15 (2)
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    Living well with severe asthma
    Michelle A. Stubbs, Vanessa L. Clark, Vanessa M. McDonald
    Breathe Jun 2019, 15 (2) e40-e49; DOI: 10.1183/20734735.0165-2019

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    Living well with severe asthma
    Michelle A. Stubbs, Vanessa L. Clark, Vanessa M. McDonald
    Breathe Jun 2019, 15 (2) e40-e49; DOI: 10.1183/20734735.0165-2019
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    • Article
      • Abstract
      • Abstract
      • Introduction
      • A hallmark of severe disease: health-related quality of life
      • Strategies to improve quality of life
      • Conclusion: future needs
      • Footnotes
      • References
    • Figures & Data
    • Info & Metrics
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    • Asthma and allergy
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