Political Agenda As Treatment Plan

According to a 9 May 2007 news release, Zero Tolerance to Asthma Attacks - Make Asthma a Political and Medical Priority, a “group of medical experts and patient representatives today called on politicians, clinicians, regulators and colleagues to take immediate action and work together to ease the plight of the 32 million people in Europe with asthma, and free up more than eight million hospital days each year. The statement is part of the Brussels Declaration, a ten point action plan to challenge the current status quo and make asthma a political and medical priority.”

These excerpts characterize the Declaration:

The ten points identified for action are summarized as follows:

1. All stakeholders must recognize asthma as a serious public health issue and consequently make asthma care a political priority.

2. Policy makers and Professional Bodies, including European Patients’ Associations must respond now to the developing understanding of asthma including recognition as a respiratory manifestation of systemic inflammatory processes.

3. The medical community, guided by its Professional Bodies, must ensure that it rapidly responds to the latest scientific understanding of asthma, recognising that asthma presents differently for adults, children and infants and different ethnic groups and management cannot necessarily be extrapolated from one group to the other. Studies and recommendations must recognise this.

4. There should be an immediate update of the European Medicines Agency (EMEA) Regulatory Guidance Note on asthma which is essential to ensure that asthma treatment and diagnosis responds to the latest scientific knowledge, clinical and real world experience, and that relevant national organisations, including patient groups and organisations, should be involved in a process for an ongoing and timely update of asthma management guidelines for both adults and children, backed by support for clinicians and patient organisations to help them integrate these guidelines into practice.

5. Guidelines should continue to use the results of traditional randomised clinical trials where these add to our understanding; however, in addition, they should seek evidence from other studies such as health economic and health outcomes studies that focus on a broader range of end points and patients that reflect ‘real-world’ patient care and family life including studies that particularly address the child/infant.

6. Funders at national and EU level must consider funding new studies that help to answer questions about the impact of co-morbidities on asthma, how to promote adherence to optimal treatment by both professionals and patients and advance patient-centred care, effective prevention strategies and prevalence studies.

7. Policy makers, politicians, clinicians and third parties (including those representing patients’ perspectives and opinions) must explore variation in asthma care across Europe and distinguish between normal variation due to differences in healthcare systems and cultures, and variation that can be reduced through policies that improve organization of care and clinical practice and create a more informed and engaged public who are aware of the needs of patients with asthma and allergies.

8. National policies should incentivize the organization of care so that people with asthma can actively participate in and make choices about their care. The EU and national agencies must improve their ongoing pharmacovigilance processes and medical utilisations in asthma to ensure that medications are used appropriately and that potential safety issues in terms of medicines and their usage are quickly and clearly identified, communicated and monitored.

9. The EU and national governments must liaise with other agencies to understand and reduce the impact of environmental factors on asthma such as smoking, air pollution, hazards in schools, day care, the work place and home, as well as other environmental triggers.

10. National policies should set targets for healthcare providers to keep registries, reduce hospitalisations, emergency healthcare use, days off work and days off school experienced by people with asthma and encourage use of tools/instruments to assess asthma control and reasons for poor control where it exists in the individual.

Commentary

The importance of treating asthma optimally is unquestioned.

And, the importance of treating major depression optimally is unquestioned.

And, the importance of treating cardiac disease, AIDS, tuberculosis, traumatic head injury syndromes, schizophrenia, … optimally is unquestioned.

Can they all have priority?

Is competitive lobbying the best use of the talents and time of medical experts?

Is a disease by disease approach to compliance, as exemplified in such clauses as “National policies should incentivize the organization of care so that people with asthma can actively participate in and make choices about their care” and “Funders at national and EU level must consider funding new studies that help to answer questions about the impact of co-morbidities on asthma, how to promote adherence to optimal treatment by both professionals and patients and advance patient-centred care, effective prevention strategies and prevalence studies.” viable?

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