Improve the management of severe asthma, optimizing the patient’s diagnostic and therapeutic path through the centralization of the figure of the general practitioner and a closer and more effective collaboration between local medicine and specialist. This is the goal of Red Carpet, an innovative project that plans to select some potentially uncontrolled asthmatic patients, upon evaluation of the medical records at the family doctor, and to submit them to the main tests for the diagnosis of severe asthma in the doctor’s office, thanks to the support of a nurse who will carry out the screening tests (spirometry, prick test, Total IgE, asthma control test), for a maximum time of one hour for each patient. This is what is reported in an article published on the Allies for Health website (www.alleatiperlasalute.it), the portal dedicated to medical-scientific information created by Novartis.
The project was born from an idea of Diego Bagnasco, head of the Severe Asthma Center at the Respiratory Diseases and Allergology Clinic of the San Martino Polyclinic in Genoa, and of Pierclaudio Brasesco, general practitioner at the Asl 3 of Genoa and president of the Cooperative of general practitioners and pediatricians of free choice Medicoop Liguria, which Aleati per la Salute interviewed.
But what is the difference between severe asthma and uncontrolled asthma? “Uncontrolled asthma – explains Bagnasco – is a form of disease that is not kept under control for a series of reasons: first of all poor adherence to therapy; they follow an underdosed therapy, or an incorrect diagnosis of asthma. comorbidities, such as rhinosinusitis and gastro-oesophageal reflux, can contribute to the poor control of symptoms. By severe asthma, on the other hand, we mean a form of asthma that remains uncontrolled, despite the patient taking the maximum dose of inhaled drug that can be prescribed. severe asthma have at least 1-2 disease flare-ups per year, for which cortisone is taken systemically (tablets or injections). ”
Within the current management of the asthmatic patient there is no shortage of critical aspects, which must be highlighted both from the point of view of the general practitioner and that of the specialist doctor. “The lack of time and organization of a clinic dedicated to chronic diseases”, as well as “the lack of adequate nursing support” and “the lack of real interactive networks between general practitioner and pulmonologist”, are, according to Brasesco, “serious shortcomings, which negatively affect the patient’s diagnosis and treatment process, lengthening the time needed to reach an adequate therapy”.
From the specialist’s point of view, “one of the major difficulties – emphasizes Bagnasco – is not to consider one’s asthma as uncontrolled. Patients often believe it is sustainable to use cortisone tablets, which is no longer acceptable, except in particular cases. The second difficulty is that of being able to access national reference centers, due to the long waiting lists. A third difficulty is that of being able to quickly carry out the necessary checks to make a quick diagnosis “. Therefore, the question of the timing of intervention remains central, together with the need for greater awareness of the disease by the patient himself.
Hence the need to identify and test new assistance processes that allow for more timely and profitable management. In this perspective, initiative medicine assumes an important role which, as Brasesco explains, “consists in actively promoting the participation of one’s client / patient in the promotion of his own health, in the prevention of diseases and their complications”.
The Red Carpet project was designed to allow patients to carry out a complete screening in a single appointment, a practical and useful way to remove the obstacle of long waiting times and arrive quickly to the diagnosis. “With the Red Carpet project – concludes Bagnasco – a better link with general practitioners has been made possible, increasing the speed of screening patients, and allowing them to access national reference centers for severe asthma. our experience the project is proving very virtuous, also managing to collaborate with local medicine, creating a strong link to act on this particular type of patient, allowing us to provide targeted therapies, such as biological ones, to patients who would otherwise remain poorly controlled ” .
The full article is available on: https://www.alleatiperlasalute.it/il-dialogo-conta/progetto-red-carpet-la-parola-agli-esperti.
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