1.Management of asthma in adults in primary care
Andrea Ban Yu-lin ; Azza Omar ; Chong Li Yin ; Hilmi Lockman ; Ida Zaliza Zainol Abidin ; Irfhan Ali Hyder Ali ; Jaya Muneswarao Ramadoo@Devudu ; Leong Swee Wei ; Mazapuspavina Md. Yasin ; Mohd Aminuddin Mohd Yusof ; Mohd. Arif Mohd. Zim ; Nor Azila Mohd. Isa ; Shamsuriani Md. Jamal ; Yoon Chee Kin ; Zul Imran Malek Abdol Hamid
Malaysian Family Physician 2018;13(3):20-26
Asthma is a chronic inflammatory disease of the airway which is often misdiagnosed and
undertreated. Early diagnosis and vigilant asthma control are crucial to preventing permanent
airway damage, improving quality of life and reducing healthcare burdens. The key approaches
to asthma management should include patient empowerment through health education and selfmanagement and, an effective patient-healthcare provider partnership.
2.Personalised management of Chronic Obstructive Pulmonary Disease (COPD): Malaysian consensus algorithm for appropriate use of inhaled corticosteroid (ICS) in COPD patients
Nurhayati Mohd Marzuki ; Mat Zuki Mat Jaeb ; Andrea Ban ; Ahmad Izuanuddin Ismail ; Irfhan Ali Hyder Ali ; Mohd Razali Norhaya ; Azlina Samsudin ; Mona Zaria Nasaruddin ; Rozanah Abd Rahman ; Mohd Arif Mohd Zim ; Razul Md. Nazri B Md Kassim ; Yoke Fong Lam ; Aishah Ibrahim ; Noor Aliza Mohd Tarekh ; Sandip Vasantrao Kapse
The Medical Journal of Malaysia 2020;75(6):717-721
Background: Regarding the long-term safety issues with the
use of inhaled corticosteroids (ICS) and the clinical
predominance of dual bronchodilators in enhancing
treatment outcomes in chronic obstructive pulmonary
disease (COPD), ICS is no longer a “preferred therapy”
according to the Global Initiative for Chronic Obstructive
Lung Disease except on top of a dual bronchodilator. This
has necessitated a change in the current therapy for many
COPD patients.
Objective: To determine a standardised algorithm to
reassess and personalise the treatment COPD patients
based on the available evidence.
Methods: A consensus statement was agreed upon by a
panel of pulmonologists in from 11 institutes in Malaysia
whose members formed this consensus group.
Results: According to the consensus, which was
unanimously adopted, all COPD patients who are currently
receiving an ICS-based treatment should be reassessed
based on the presence of co-existence of asthma or high
eosinophil counts and frequency of moderate or severe
exacerbations in the previous 12 months. When that the
patients meet any of the aforementioned criteria, then the
patient can continue taking ICS-based therapy. However, if
the patients do not meet the criteria, then the treatment of
patients need to be personalised based on whether the
patient is currently receiving long-acting beta-agonists
(LABA)/ICS or triple therapy.
Conclusion: A flowchart of the consensus providing a
guidance to Malaysian clinicians was elucidated based on
evidences and international guidelines that identifies the
right patients who should receive inhaled corticosteroids
and enable to switch non ICS based therapies in patients
less likely to benefit from such treatments.