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Louis-Philippe Boulet,
Allan Becker, Dennis Bowie,
Paul Hernandez,
Andrew McIvor,
Michel Rouleau,
Jean Bourbeau,
Ian D Graham,
Jo Logan,
France Légaré, [......],
Martin C Holroyde,
Danielle Fagnan,
Eileen Dorval,
Lisa Pogany,
Alan Kaplan,
Lisa Cicutto,
Mary L Allen,
Serge Moraca,
J Mark FitzGerald,
Francine Borduas
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ABSTRACT: The present supplement summarizes the proceedings of the symposium "Implementing practice guidelines: A workshop on guidelines dissemination and implementation with a focus on asthma and COPD", which took place in Quebec City, Quebec, from April 14 to 16, 2005. This international symposium was a joint initiative of the Laval University Office of Continuing Medical Education (Bureau de la Formation Médicale Continue), the Canadian Thoracic Society and the Canadian Network for Asthma Care, and was supported by many other organizations and by industrial partners. The objectives of this meeting were to examine the optimal implementation of practice guidelines, review current initiatives for the implementation of asthma and chronic obstructive pulmonary disease (COPD) guidelines in Canada and in the rest of the world, and develop an optimal strategy for future guideline implementation. An impressive group of scientists, physicians and other health care providers, as well as policy makers and representatives of patients' associations, the pharmaceutical industry, research and health networks, and communications specialists, conveyed their perspectives on how to achieve these goals. This important event provided a unique opportunity for all participants to discuss key issues in improving the care of patients with asthma and COPD. These two diseases are responsible for an enormous human and socioeconomic burden around the world. Many reports have indicated that current evidence-based guidelines are underused by physicians and others, and that there are many barriers to an effective translation of recommendations into day-to-day care. There is therefore a need to develop more effective ways to communicate key information to both caregivers and patients, and to promote appropriate health behaviours. This symposium contributed to the initiation of what could become the "Canadian Asthma and COPD Campaign", aimed at improving care and, hence, the quality of life of those suffering from these diseases. It is hoped that this event will be followed by other meetings that focus on how to improve the transfer of key recommendations from evidence-based guidelines into current care, and how to stimulate research to accomplish this.
Canadian respiratory journal: journal of the Canadian Thoracic Society 04/2006; 13 Suppl A:5-47. · 1.56 Impact Factor
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Catherine Lemière,
Tony Bai,
Meyer Balter,
Charles Bayliff,
Allan Becker,
Louis-Philippe Boulet, Dennis Bowie,
André Cartier,
Andrew Cave,
Kenneth Chapman, [......],
Shelagh Finlayson,
J Mark FitzGerald,
Frederick E Hargreave,
Donna Hogg,
Alan Kaplan,
Harold Kim,
Cheryle Kelm,
Paul O'Byrne,
Malcolm Sears,
Andrea White Markham
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ABSTRACT: 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.
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.
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.
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.
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.
Canadian respiratory journal: journal of the Canadian Thoracic Society 02/2004; 11 Suppl A:9A-18A. · 1.56 Impact Factor
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Catherine Lemière,
Allan Becker,
Louis-Philippe Boulet, Dennis Bowie,
André Cartier,
Donald Cockroft,
Robert Cowie,
Pierre Ernst,
Mark Fitzgerald,
Malcolm Sears,
Sheldon Spier
Canadian Medical Association Journal 11/2002; 167(9):1008-9. · 8.22 Impact Factor
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Manal Al-Hazmi,
Kate Wooldrage,
Nicholas R Anthonisen,
Margaret R Becklake, Dennis Bowie,
Moira Chan-Yeung,
Helen Dimich-Ward,
Pierre Ernst,
Jure Manfreda,
Malcolm R Sears,
Hans C Siersted,
Lamont Sweet,
Linda Van Til
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ABSTRACT: Airflow obstruction is relatively uncommon in young adults, and may indicate potential for the development of progressive disease. The objective of the present study was to enumerate and characterize airflow obstruction in a random sample of Canadians aged 20 to 44 years.
The sample (n=2962) was drawn from six Canadian sites.
A prevalence study using the European Community Respiratory Health Survey protocol was conducted. Airflow obstruction was assessed by spirometry. Bronchial responsiveness, skin reactivity to allergens and total serum immunoglobulin E were also measured. Logistic regression was used for analysis.
Airflow obstruction was observed in 6.4% of the sample, not associated with sex or age. The risk of airflow obstruction increased in patients who had smoked and in patients who had lung trouble during childhood. Adjusted for smoking, the risk of airflow obstruction was elevated for subjects with past and current asthma, skin reactivity to allergens, elevated levels of total immunoglobulin E and bronchial hyper-responsiveness. Of the subjects with airflow obstruction, 21% were smokers with a history of asthma, 50% were smokers without asthma, 12% were nonsmokers with asthma and 17% were nonsmokers with no history of asthma. Bronchial hyper-responsiveness increased the prevalence of airflow obstruction in each of these groups.
Smoking and asthma, jointly and individually, are major determinants of obstructive disorders in young adults. Bronchial hyper-responsiveness contributes to obstruction in both groups.
Canadian respiratory journal: journal of the Canadian Thoracic Society 14(4):221-7. · 1.56 Impact Factor
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M Diane Lougheed,
Catherine Lemiere,
Sharon Dell,
Francine Ducharme,
J Mark Fitzgerald,
Richard Leigh,
Chris Licskai,
Brian H Rowe, Dennis Bowie,
Allan Becker,
Louis-Philippe Boulet
Canadian respiratory journal: journal of the Canadian Thoracic Society 17(2):57-60. · 1.56 Impact Factor
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M Diane Lougheed,
Catherine Lemiere,
Sharon Dell,
Francine Ducharme,
J Mark FitzGerald,
Richard Leigh,
Chris Licskai,
Brian H Rowe, Dennis Bowie,
Allan Becker,
Louis-Philippe Boulet
