Friday, March 19, 2010
When I was a medical student and then when I taught medical students and residents, I used mnemonics. Here's my mnemonic for when asthma remained poorly controlled. It's based on my reaction when patients aren't responding well to a treatment plan.
Wrong diagnosis. All that wheezes is not asthma.
Heterogeneity of asthma. The causes of the asthma are not all treated identically.
Adherence is poor, or non-compliance. Not taking meds when instructed.
Technique is poor. Example, not taking inhalers properly.
Secondary factor. Coexisting disease or drug interaction is preventing an optimal response to the treatment.
Understanding is poor. Patients or caregivers do not understand why the meds should be taken.
Pathway resistance. Patients have some difference in their physiology which prevents them from responding well to a traditional therapy despite being given to one who's correctly diagnosed and instructed. Example - steroid resistance.Think about this when your asthma or your loved one's asthma is not responding quickly and easily to your treatment plan.