Asthma: Medical Needs And Dilemmas by Harold M. Koenig, M.D. (NAPSA)—In my experience as Surgeon General of the Navy, I learned that the best way to manage asthmais to better inform the people who have the disease and the people whotreatit. Asthmais generally characterized by wide and sometimes rapid fluctuations in a person’s ability to move air in and out of the lungs. Unfortunately, that description is about the only standardized information doctors have to use as a diagnostic tool. There is a poor understanding of the mechanisms of asthma and there is not a universally accepted definition of asthma. This hinders both epidemiology and patient care. Further, there are few records about the disease recording how many people have asthma, at what age they are diagnosed and if their symptoms are chronic. This tracking mater- ial is necessary for determining trends and correlations in the disease and its occurrences. All this is surprising, given that cases of asthma maybeincreasing at an alarming rate. Doctors are clamoring for more than just sub- jective reporting of symptomsto define an asthmaepisode. They are asking for objective criteria for diagnosis. They also recognize that without better reporting standards and data, the healthcare community finds itself in the midst of a medical managementfailure. Too often asthmatics, and some- Asthma Prevalence Rate +42% Vv 49,4) 34,7 par 1,000 1982 1992 1,000 Source: Asthma-United States, 1982-1992. MMWR 1995:43:952 @ A new educational campaign may lead to the better managementof asthma. times doctors, do not take the dis- ease as seriously as they should. Too many asthmatics in the United States go needlessly to emergency rooms, or even die, because of improper disease management. Currently the Federal Government, through the National Institutes of Health and Centers for Disease Control, is starting an education campaign with school nurses, parents, doctors, and asth- matics to better managethis con- dition in homes, schools, and com- munities. This is a goodfirst step, hopefully with many more steps to follow. Harold M. Koenig, M.D. is chairman and president, The Annapolis Center.
