Page 161 - Comprehensive treatment of patients with glucocorticoid-dependent severe asthma

predicted by patient characteristics, such as age, blood eosinophils and degree of asthma control before admission. This indicates that, also for high-altitude climate treatment, it is possible to formulate a management strategy tailored to the individual characteristics and needs.
Chapter 5 includes a reflection about the recent development and introduction of anti-interleukin (IL)-5 for the treatment of patients with severe eosinophilic asthma. The DREAM trial [16] demonstrated the efficacy of anti IL-5 in reducing asthma exacerbations in patients with this specific phenotype. In this chapter we provide a critical perspective about this targeted therapy and conclude that despite the positive results from the DREAM study there are still remaining questions to be explored during the long-term follow-up of treated patients.
Telemanagement in asthma
Chapter 6 encompasses a broad review of literature about internet applications for the management of patients with asthma, focusing on the effectiveness and implementation of this approach in the patient care. Based on this review we propose that telemanagement of asthma in the individual patient should include key components of asthma management, such as education, self- monitoring, goal setting, written action plans and regular medical review (Figure 1).
We concluded that telemanagement strategies can be an effective tool for the tailored treatment of patients with asthma, particularly for those at higher risk of worsening of asthma. Further research is needed on the long-term value and cost-effectiveness of telemanagement of patients with asthma under real world conditions and on implementation strategies.
Summary and general discussion
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