The impact of dysfunctional breathing on the assessment of asthma control

OBJECTIVE: To assess the degree of asthma control achieved by patients with asthma in Canada and to describe the impact of poor asthma control.DESIGN: Population-based, cross-sectional telephone interview survey of Canadians with doctor-diagnosed asthma.SUBJECTS AND METHODS: Random digit dialing was used to identify a representative sample of Canadians with asthma. A total of 801 adults and 200 parents of children aged four to 15 years were interviewed over the telephone. Telephone interviews were also conducted with 266 physicians.RESULTS: Only 24% of patients achieved disease control by meeting the six symptom-based criteria listed by the 1996 Canadian Asthma Consensus Guidelines as appropriate treatment targets. Fifty-seven per cent of patients failed to meet two or more of the six control criteria and were considered poorly controlled. Fifty-one per cent had required urgent care for out of control asthma at least once in the year before the survey. Nonetheless, 91% of patients thought that their asthma was adequately controlled. Physicians shared this optimism: 77% of family physicians and 90% of respirologists believed that they were usually able to achieve optimal asthma control in their patients. Few physicians gauged asthma control by tracking more than one or two symptoms, and just over one-half (54%) of patients surveyed recalled ever having had a lung function test. One-half (48%) of patients with poorly controlled asthma who used inhaled steroids did not understand the role of inhaled steroids; onethird (32%) of patients with poorly controlled asthma who used short acting bronchodilators misunderstood the action of quick relief bronchodilators.CONCLUSIONS: The majority of Canadians with asthma suffer from inadequate control of their disease. Suboptimal control of asthma is associated with excess health care use. Inadequate monitoring by physicians and poor patient education may be factors contributing to this problem.

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Level of asthma control and its impact on activities of daily living in asthma patients in Brazil

Jornal Brasileiro de Pneumologia ◽

10.1590/s1806-37132013000500002 ◽

2013 ◽

Vol 39 (5) ◽

pp. 532-538 ◽

Cited By ~ 16

Author(s):

Mariana Rodrigues Gazzotti ◽

Oliver Augusto Nascimento ◽

Federico Montealegre ◽

James Fish ◽

Jose Roberto Jardim

Keyword(s):

Quality Of Life ◽

Activities Of Daily Living ◽

Emergency Room ◽

Asthma Control ◽

Daily Living ◽

Negative Impact ◽

Uncontrolled Asthma ◽

School Work ◽

The Impact

OBJECTIVE: To evaluate the impact of asthma on activities of daily living and on health status in patients with controlled, partially controlled, or uncontrolled asthma in Brazil. METHODS: We used data related to 400 patients in four Brazilian cities (São Paulo, Rio de Janeiro, Salvador, and Curitiba), obtained in a survey conducted throughout Latin America in 2011. All study subjects were > 12 years of age and completed a standardized questionnaire in face-to-face interviews. The questions addressed asthma control, hospitalizations, emergency room visits, and school/work absenteeism, as well as the impact of asthma on the quality of life, sleep, and leisure. The level of asthma control was determined in accordance with the Global Initiative for Asthma criteria. RESULTS: Among the 400 respondents, asthma was controlled in 37 (9.3%), partially controlled in 226 (56.5%), and uncontrolled in 137 (34.2%). The numbers of patients with uncontrolled or partially controlled asthma who visited the emergency room, who were hospitalized, and who missed school/work were higher than were those of patients with controlled asthma (p = 0.001, p = 0.05, and p = 0.01, respectively). Among those with uncontrolled asthma, the impact of the disease on activities of daily living, sleep, social activities, and normal physical exertion was greater than it was among those with controlled or partially controlled asthma (p < 0.001). CONCLUSIONS: In Brazil, asthma treatment should be monitored more closely in order to increase treatment adherence and, consequently, the level of asthma control, which can improve patient quality of life and minimize the negative impact of the disease.

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Childhood Asthma Control Test in asthmatic children with dysfunctional breathing

Journal of Allergy and Clinical Immunology ◽

10.1016/j.jaci.2007.06.049 ◽

2008 ◽

Vol 121 (1) ◽

pp. 266-267 ◽

Cited By ~ 8

Author(s):

Diego G. Peroni ◽

Giorgio L. Piacentini ◽

Alessandro Bodini ◽

Attilio L. Boner

Keyword(s):

Asthma Control ◽

Childhood Asthma ◽

Control Test ◽

Asthma Control Test ◽

Asthmatic Children ◽

Dysfunctional Breathing

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Factors affecting asthma psychomorbidity, control and illness-related quality of life: what is the interaction?

European Psychiatry ◽

10.1016/s0924-9338(11)73449-6 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 1745-1745

Author(s):

N. Pilipenko ◽

M. Karekla

Keyword(s):

Quality Of Life ◽

Asthma Control ◽

Research Literature ◽

Smoking History ◽

Inflammatory Disorder ◽

Chronic Inflammatory Disorder ◽

Asthma Patients ◽

Related Quality ◽

The Impact

Asthma is a chronic inflammatory disorder of the airways, ounknown etiology and growing prevalence (GINA, 2009). Appropriate asthma management can control the disorder and enable patients to enjoy a good quality of life (WHO, 2007).Yet, many asthma patients are unable to maintain asthma control (Rabe et al., 2003) for various reasons, including psychological ones (Feldman et al., 2005).This study examined the prevalence of psychomorbidity, and its interaction with asthma control difficulties and asthma-related quality of life in a sample of 200 asthma patients in Cyprus. Asthma diagnoses and severity were established by medical chart review.Psychomorbidity was evaluated using the Patient Health Questionnaire (Spitzer, 1999). Additionally, the impact of asthma-specific (e.g. asthma knowledge), health-specific (e.g. smoking history) and socio-demographic (e.g. perceived poverty) factors was examined as prior research literature suggests these may significantly impact asthma control and asthma-related quality of life.Currently, the present study is in its final stages of data collection (to conclude 2010). The results will offer valuable insights into the mechanisms and factors which affect asthma control, quality of life, and psychomorbidity. In doing so, the present study will contribute to the improved understanding of asthma patients’ experiences, essential to guide medical and psychological interventions.

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The impact of a dedicated physiotherapist clinic for children with dysfunctional breathing

ERJ Open Research ◽

10.1183/23120541.00103-2015 ◽

2016 ◽

Vol 2 (3) ◽

pp. 00103-2015 ◽

Cited By ~ 8

Author(s):

Nicola J. Barker ◽

Heather Elphick ◽

Mark L. Everard

Keyword(s):

Quality Of Life ◽

Long Term Effects ◽

Time Points ◽

Significant Difference ◽

Breathing Retraining ◽

Dysfunctional Breathing ◽

The Uk ◽

The Impact ◽

Time Point

Dysfunctional breathing is a significant cause of morbidity, adversely affecting an individual's quality of life. There is currently no data from paediatric centres on the impact of breathing retraining for dysfunctional breathing.Symptoms and quality of life were measured in 34 subjects referred sequentially for breathing retraining to the first dedicated paediatric dysfunctional breathing clinic in the UK. Data were obtained prior to the first intervention (time point 1), at discharge (time point 2) and by post 6 months later (time point 3).The mean (interquartile range) age of participants was 13.3 (9.1–16.3) years, with 52% female. Data were obtained at time points 2 and 3 in 23 and 13 subjects, respectively.Statistically significant improvements were observed in symptom scores, child quality of life and parental proxy quality of life between time points 1 and 2 (p<0.0001), while there was no significant difference in the data at time point 3 as compared with time point 2.This study suggests that physiotherapist-led breathing retraining offers significant benefit to young people with dysfunctional breathing which is maintained for at least 6 months after treatment is completed. Future studies will provide more information on the long-term effects of interventions for dysfunctional breathing.

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The impact of poor asthma control among asthma patients treated with inhaled corticosteroids plus long-acting β2-agonists in the United Kingdom: a cross-sectional analysis

npj Primary Care Respiratory Medicine ◽

10.1038/s41533-017-0014-1 ◽

2017 ◽

Vol 27 (1) ◽

Cited By ~ 21

Author(s):

Ian D. Pavord ◽

Nicola Mathieson ◽

Anna Scowcroft ◽

Riccardo Pedersini ◽

Gina Isherwood ◽

...

Keyword(s):

United Kingdom ◽

Asthma Control ◽

Inhaled Corticosteroids ◽

Cross Sectional ◽

The United Kingdom ◽

Asthma Patients ◽

Long Acting ◽

Sectional Analysis ◽

The Impact ◽

Β2 Agonists

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The Impact of Nationally Coordinated Pharmacy-Based Asthma Education Intervention

Canadian Respiratory Journal ◽

10.1155/2001/380485 ◽

2001 ◽

Vol 8 (4) ◽

pp. 261-265 ◽

Cited By ~ 22

Author(s):

Shelley Anne Diamond ◽

Kenneth Ross Chapman

Keyword(s):

Asthma Control ◽

Educational Intervention ◽

Self Management ◽

Community Pharmacies ◽

Inhaler Technique ◽

Short Acting ◽

Management Behaviour ◽

Preventive Medication ◽

The Impact

OBJECTIVE: To assess the impact of a nationally coordinated pharmacy-based educational intervention on self-management behaviour and markers of asthma control in self-referred patients with asthma.DESIGN: An asthma clinic day was set up by a national chain of community pharmacies whereby pharmacists used a structured questionnaire to assess asthma control and self-care among self-referred patients with doctor-diagnosed asthma. In a one-on-one counselling session, each patient's educational needs were identified and the appropriate education offered. A telephone follow-up 30 days later assessed the impact of teaching.SETTING: Community pharmacies across Canada.OUTCOME MEASURES: The follow-up questionnaire quantified the number of wheezing episodes or other symptoms per week, the number of night-time awakenings per week, and the frequency of use of reliever and preventive medications.RESULTS: Of 4080 patients assessed, 22.2% used an inadequate inhaler technique, 16.4% used a short acting beta2-agonist excessively and 21.0% were not using an inhaled corticosteroid daily despite a frequency of symptoms that would suggest that it was needed. Common educational interventions included a review of inhaler technique (41.9%), a recommendation for regular inhaled corticosteroids (31.5%) and a referral to the primary care physician (21.0%). Thirty days after the educational intervention, patients reported significant decreases in the frequency of daytime asthma symptoms, the frequency of nocturnal symptoms and the frequency with which short acting beta2-agonists were used, while reporting significant increases in their use of preventive medication.CONCLUSIONS: A brief assessment and an educational intervention in the community pharmacy can produce significant short term improvements in patient-reported symptom control and appropriate self-management behaviour.

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