Browsing by Author "Ducharme, Francine M"

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    Adult Asthma Consensus Guidelines Update 2003
    (2004-01-01) Lemière, Catherine; Bai, Tony; Balter, Meyer; Bayliff, Charles; Becker, Allan; Boulet, Louis-Philippe; Bowie, Dennis; Cartier, André; Cave, Andrew; Chapman, Kenneth; Cowie, Robert; Coyle, Stephen; Cockcroft, Donald; Ducharme, Francine M; Ernst, Pierre; Finlayson, Shelagh; FitzGerald, J Mark; Hargreave, Frederick E; Hogg, Donna; Kaplan, Alan; Kim, Harold; Kelm, Cheryle; O’Byrne, Paul; Sears, Malcolm; Markham, Andrea White; on behalf of the Canadian Adult Consensus Group of the Canadian Thoracic Society,
    BACKGROUND: Several sets of Canadian guidelines for the diagnosis and management of asthma have been published over the past 15 years. Since the last revision of the 1999 Canadian Asthma Consensus Report, important new studies have highlighted the need to incorporate new information into the asthma guidelines.OBJECTIVES: To review the literature on adult asthma management published between January 2000 and June 2003; to evaluate the influence of the new evidence on the recommendations made in the 1999 Canadian Asthma Consensus Guidelines and its 2001 update; and to report new recommendations on adult asthma management.METHODS: Three specific topics for which new evidence affected the previous recommendations were selected for review: initial treatment of asthma, add-on therapies in the treatment of asthma and asthma education. The resultant reviews were discussed in June 2003 at a meeting under the auspices of the Canadian Thoracic Society, and recommendations for adult asthma management were reviewed.RESULTS: The present report emphasises the importance of the early introduction of inhaled corticosteroids in symptomatic patients with mild asthma; stresses the benefit of adding additional therapy, preferably long-acting beta2-agonists, to patients incompletely controlled on low doses of inhaled corticosteroids; and documents the essential role of asthma education.CONCLUSION: The present report generally supports many of the previous recommendations published in the 1999 Canadian Asthma Consensus Report and provides higher levels of evidence for a number of those recommendations.
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    Canadian Society of Allergy and Clinical Immunology annual scientific meeting 2016
    (2017-04-07) Alsayegh, Mohammad A; Alshamali, Hanan; Khadada, Mousa; Ciccolini, Amanda; Ellis, Anne K; Quint, Diana; Powley, William; Lee, Laurie; Fiteih, Yahya; Baksh, Shairaz; Vliagoftis, Harissios; Gerega, Sebastien K; Millson, Brad; Charland, Katia; Barakat, Stephane; Sun, Xichun; Jimenez, Ricardo; Waserman, Susan; FitzGerald, Mark J; Hébert, Jacques; Cognet-Sicé, Josiane; Renahan, Kevin E; Huq, Saiful; Chooniedass, Rishma; Sawyer, Scott; Pasterkamp, Hans; Becker, Allan; Smith, Steven G; Zhang, Shiyuan; Jayasundara, Kavisha; Tacon, Claire; Simidchiev, Alex; Nadeau, Gilbert; Gunsoy, Necdet; Mullerova, Hana; Albers, Frank; Kim, Young W; Shannon, Casey P; Singh, Amrit; Neighbour, Helen; Larché, Mark; Tebbutt, Scott J; Klopp, Annika; Vehling, Lorena; Becker, Allan B; Subbarao, Padmaja; Mandhane, Piushkumar J; Turvey, Stuart E; Sears, Malcolm R; Azad, Meghan B; Loewen, Keely; Monchka, Barret; Mahmud, Salaheddin M; Jong, Geert ‘; Longo, Cristina; Bartlett, Gillian; Ducharme, Francine M; Schuster, Tibor; MacGibbon, Brenda; Barnett, Tracie; North, Michelle L; Brook, Jeff; Lee, Elizabeth; Omana, Vanessa; Thiele, Jenny; Steacy, Lisa M; Evans, Greg; Diamond, Miriam; Sussman, Gordon L; Amistani, Yann; Abiteboul, Kathy; Tenn, Mark W; Yang, ChenXi; Carlsten, Christopher; Conway, Edward M; Mack, Douglas; Othman, Yasmin; Barber, Colin M; Kalicinsky, Chrystyna; Burke, Andrea E; Messieh, Mary; Nair, Parameswaran; Che, Chun T; Douglas, Lindsay; Liem, Joel; Duan, Lucy; Miller, Charlotte; Dupuis, Pascale; Connors, Lori A; Fein, Michael N; Shuster, Joseph; Hadi, Hani; Polk, Brooke; Raje, Nikita; Labrosse, Roxane; Bégin, Philippe; Paradis, Louis; Roches, Anne D; Lacombe-Barrios, Jonathan; Mishra, Sanju; Lacuesta, Gina; Chiasson, Meredith; Haroon, Babar; Robertson, Kara; Issekutz, Thomas; Leddin, Desmond; Couban, Stephen; Connors, Lori; Roos, Adrienne; Kanani, Amin; Chan, Edmond S; Schellenberg, Robert; Rosenfield, Lana; Cvetkovic, Anna; Woodward, Kevin; Quirt, Jaclyn; Watson, Wade T A; Castilho, Edson; Sullivan, Jennifer A; Temple, Beverley; Martin, Donna; Cook, Victoria E; Mills, Christopher; Portales-Casamar, Elodie; Fu, Lisa W; Ho, Alexander; Zaltzman, Jeffrey; Chen, Lucy; Vadas, Peter; Gabrielli, Sofianne; Clarke, Ann; Eisman, Harley; Morris, Judy; Joseph, Lawrence; LaVieille, Sebastien; Ben-Shoshan, Moshe; Graham, François; Barnes, Charles; Portnoy, Jay; Stagg, Vincent; Simons, Elinor; Lefebvre, Diana; Dai, David; Mandhane, Piushkumar; Sears, Malcolm; Tam, Herman; Simons, F. E R; Alotaibi, Dhaifallah; Dawod, Bassel; Tunis, Matthew C; Marshall, Jean; Desjardins, Marylin; Béland, Marianne; Lejtenyi, Duncan; Drolet, Jean-Phillipe; Lemire, Martine; Tsoukas, Christos; Noya, Francisco J; Alizadehfar, Reza; McCusker, Christine T; Mazer, Bruce D; Maestre-Batlle, Danay; Gunawan, Evelyn; Rider, Christopher F; Bølling, Anette K; Pena, Olga M; Suez, Daniel; Melamed, Isaac; Hussain, Iftikhar; Stein, Mark; Gupta, Sudhir; Paris, Kenneth; Fritsch, Sandor; Bourgeois, Christelle; Leibl, Heinz; McCoy, Barbara; Noel, Martin; Yel, Leman; Scott, Ori; Reid, Brenda; Atkinson, Adelle; Kim, Vy H; Roifman, Chaim M; Grunebaum, Eyal; AlSelahi, Eiman; Aleman, Fernando; Oberle, Amber; Trus, Mike; Sussman, Gordon; Kanani, Amin S; Chambenoi, Olivier; Chiva-Razavi, Sima; Grodecki, Savannah; Joshi, Nikhil; Menikefs, Peter; Holt, David; Pun, Teresa; Tworek, Damian; Hanna, Raphael; Heroux, Delia; Rosenberg, Elli; Stiemsma, Leah; Turvey, Stuart; Denburg, Judah; Mill, Christopher; Teoh, Timothy; Zimmer, Preeti; Avinashi, Vishal; Paina, Mihaela; Darwish Hassan, Ahmed A; Oliveria, John P; Olesovsky, Chris; Gauvreau, Gail; Pedder, Linda; Keith, Paul K; Plunkett, Greg; Bolner, Michelle; Pourshahnazari, Persia; Stark, Donald; Vostretsova, Kateryna; Moses, Andrew; Wakeman, Andrew; Singer, Alexander; Gerstner, Thomas; Abrams, Elissa; Johnson, Sara F; Woodgate, Roberta L
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    Canadian Thoracic Society 2012 Guideline Update: Diagnosis and Management of Asthma in Preschoolers, Children and Adults
    (2012-01-01) Lougheed, M Diane; Lemiere, Catherine; Ducharme, Francine M; Licskai, Chris; Dell, Sharon D; Rowe, Brian H; FitzGerald, Mark; Leigh, Richard; Watson, Wade; Boulet, Louis-Philippe; Canadian Thoracic Society Asthma Clinical Assembly,
    BACKGROUND: In 2010, the Canadian Thoracic Society (CTS) published a Consensus Summary for the diagnosis and management of asthma in children six years of age and older, and adults, including an updated Asthma Management Continuum. The CTS Asthma Clinical Assembly subsequently began a formal clinical practice guideline update process, focusing, in this first iteration, on topics of controversy and/or gaps in the previous guidelines.METHODS: Four clinical questions were identified as a focus for the updated guideline: the role of noninvasive measurements of airway inflammation for the adjustment of anti-inflammatory therapy; the initiation of adjunct therapy to inhaled corticosteroids (ICS) for uncontrolled asthma; the role of a single inhaler of an ICS/long-acting beta2-agonist combination as a reliever, and as a reliever and a controller; and the escalation of controller medication for acute loss of asthma control as part of a self-management action plan. The expert panel followed an adaptation process to identify and appraise existing guidelines on the specified topics. In addition, literature searches were performed to identify relevant systematic reviews and randomized controlled trials. The panel formally assessed and graded the evidence, and made 34 recommendations.RESULTS: The updated guideline recommendations outline a role for inclusion of assessment of sputum eosinophils, in addition to standard measures of asthma control, to guide adjustment of controller therapy in adults with moderate to severe asthma. Appraisal of the evidence regarding which adjunct controller therapy to add to ICS and at what ICS dose to begin adjunct therapy in children and adults with poor asthma control supported the 2010 CTS Consensus Summary recommendations. New recommendations for the adjustment of controller medication within written action plans are provided. Finally, priority areas for future research were identified.CONCLUSIONS: The present clinical practice guideline is the first update of the CTS Asthma Guidelines following the Canadian Respiratory Guidelines Committee’s new guideline development process. Tools and strategies to support guideline implementation will be developed and the CTS will continue to regularly provide updates reflecting new evidence.
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    Canadian Thoracic Society 2012 Guideline Update: Diagnosis and Management of Asthma in Preschoolers, Children and Adults: Executive Summary
    (2012-01-01) Lougheed, M Diane; Lemiere, Catherine; Ducharme, Francine M; Licskai, Chris; Dell, Sharon D; Rowe, Brian H; FitzGerald, Mark; Leigh, Richard; Watson, Wade; Boulet, Louis-Philippe; Canadian Thoracic Society Asthma Clinical Assembly,
    BACKGROUND: In 2010, the Canadian Thoracic Society (CTS) published a Consensus Summary for the diagnosis and management of asthma in children six years of age and older, and adults, including an updated Asthma Management Continuum. The CTS Asthma Clinical Assembly subsequently began a formal clinical practice guideline update process, focusing, in this first iteration, on topics of controversy and/or gaps in the previous guidelines.METHODS: Four clinical questions were identified as a focus for the updated guideline: the role of noninvasive measurements of airway inflammation for the adjustment of anti-inflammatory therapy; the initiation of adjunct therapy to inhaled corticosteroids (ICS) for uncontrolled asthma; the role of a single inhaler of an ICS/long-acting beta2-agonist combination as a reliever, and as a reliever and a controller; and the escalation of controller medication for acute loss of asthma control as part of a self-management action plan. The expert panel followed an adaptation process to identify and appraise existing guidelines on the specified topics. In addition, literature searches were performed to identify relevant systematic reviews and randomized controlled trials. The panel formally assessed and graded the evidence, and made 34 recommendations.RESULTS: The updated guideline recommendations outline a role for inclusion of assessment of sputum eosinophils, in addition to standard measures of asthma control, to guide adjustment of controller therapy in adults with moderate to severe asthma. Appraisal of the evidence regarding which adjunct controller therapy to add to ICS and at what ICS dose to begin adjunct therapy in children and adults with poor asthma control supported the 2010 CTS Consensus Summary recommendations. New recommendations for the adjustment of controller medication within written action plans are provided. Finally, priority areas for future research were identified.CONCLUSIONS: The present document is an executive summary of the first update of the CTS Asthma Guidelines following the Canadian Respiratory Guidelines Committee’s new guideline development process. Tools and strategies to support guideline implementation will be developed and the CTS will continue to regularly provide updates reflecting new evidence.
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    Canadian Thoracic Society Asthma Management Continuum – 2010 Consensus Summary for Children Six Years of Age and Over, and Adults
    (2010-01-01) Lougheed, M Diane; Lemière, Catherine; Dell, Sharon D; Ducharme, Francine M; FitzGerald, J Mark; Leigh, Richard; Licskai, Chris; Rowe, Brian H; Bowie, Dennis; Becker, Allan; Boulet, Louis-Philippe
    BACKGROUND/OBJECTIVE: To integrate new evidence into the Canadian Asthma Management Continuum diagram, encompassing both pediatric and adult asthma.METHODS: The Canadian Thoracic Society Asthma Committee members, comprised of experts in pediatric and adult respirology, allergy and immunology, emergency medicine, general pediatrics, family medicine, pharmacoepidemiology and evidence-based medicine, updated the continuum diagram, based primarily on the 2008 Global Initiative for Asthma guidelines, and performed a focused review of literature pertaining to key aspects of asthma diagnosis and management in children six years of age and over, and adults.RESULTS: In patients six years of age and over, management of asthma begins with establishing an accurate diagnosis, typically by supplementing medical history with objective measures of lung function. All patients and caregivers should receive self-management education, including a written action plan. Inhaled corticosteroids (ICS) remain the first-line controller therapy for all ages. When asthma is not controlled with a low dose of ICS, the literature supports the addition of long-acting beta2-agonists in adults, while the preferred approach in children is to increase the dose of ICS. Leukotriene receptor antagonists are acceptable as second-line monotherapy and as an alternative add-on therapy in both age groups. Anti-immunoglobulin E therapy may be of benefit in adults, and in children 12 years of age and over with difficult to control allergic asthma, despite high-dose ICS and at least one other controller.CONCLUSIONS: The foundation of asthma management is establishing an accurate diagnosis based on objective measures (eg, spirometry) in individuals six years of age and over. Emphasis is placed on the similarities and differences between pediatric and adult asthma management approaches to achieve asthma control.