Using Global Initiative for Asthma guidelines to assess asthma severity in populations

ABSTRACT OBJECTIVE: To evaluate quality of life according to the level of asthma control and degree of asthma severity in children and adolescents. METHODS: We selected children and adolescents with asthma (7-17 years of age) from the Pediatric Pulmonology Outpatient Clinic of the State University of Campinas Hospital de Clínicas, located in the city of Campinas, Brazil. Asthma control and asthma severity were assessed by the Asthma Control Test and by the questionnaire based on the Global Initiative for Asthma, respectively. The patients also completed the Paediatric Asthma Quality of Life Questionnaire (PAQLQ), validated for use in Brazil, in order to evaluate their quality of life. RESULTS: The mean age of the patients was 11.22 ± 2.91 years, with a median of 11.20 (7.00-17.60) years. We selected 100 patients, of whom 27, 33, and 40 were classified as having controlled asthma (CA), partially controlled asthma (PCA), and uncontrolled asthma (UA), respectively. As for asthma severity, 34, 19, and 47 were classified as having mild asthma (MiA), moderate asthma (MoA), and severe asthma (SA), respectively. The CA and the PCA groups, when compared with the NCA group, showed higher values for the overall PAQLQ score and all PAQLQ domains (activity limitation, symptoms, and emotional function; p < 0.001 for all). The MiA group showed higher scores for all of the PAQLQ components than did the MoA and SA groups. CONCLUSIONS: Quality of life appears to be directly related to asthma control and asthma severity in children and adolescents, being better when asthma is well controlled and asthma severity is lower.

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Effect of asthma and asthma medication on the prognosis of patients with COVID-19

European Respiratory Journal ◽

10.1183/13993003.02226-2020 ◽

2020 ◽

Vol 57 (3) ◽

pp. 2002226 ◽

Cited By ~ 6

Author(s):

Yong Jun Choi ◽

Ju-Young Park ◽

Hye Sun Lee ◽

Jin Suh ◽

Jeung Yoon Song ◽

...

Keyword(s):

Clinical Outcomes ◽

Medical Cost ◽

Asthma Severity ◽

Asthma Medication ◽

Diagnostic Code ◽

Total Medical Cost ◽

Global Initiative For Asthma ◽

Prolonged Duration ◽

Global Initiative ◽

Poor Outcomes

BackgroundCoronavirus disease 2019 (COVID-19) has spread worldwide rapidly. However, the effects of asthma, asthma medication and asthma severity on the clinical outcomes of COVID-19 have not yet been established.MethodsThe study included 7590 de-identified patients, who were confirmed to have COVID-19 using the severe acute respiratory syndrome coronavirus 2 RNA-PCR tests conducted up to May 15, 2020; we used the linked-medical claims data provided by the Health Insurance Review and Assessment Service. Asthma and asthma severity (steps suggested by the Global Initiative for Asthma) were defined using the diagnostic code and history of asthma medication usage.ResultsAmong 7590 COVID-19 patients, 218 (2.9%) had underlying asthma. The total medical cost associated with COVID-19 patients with underlying asthma was significantly higher than that of other patients. Mortality rate for COVID-19 patients with underlying asthma (7.8%) was significantly higher than that of other patients (2.8%; p<0.001). However, asthma was not an independent risk factor for the clinical outcomes of COVID-19 after adjustment, nor did asthma medication use and asthma severity affect the clinical outcomes of COVID-19. However, use of oral short-acting β2-agonists was an independent factor to increase the total medical cost burden. Patients with step 5 asthma showed significant prolonged duration of admission compared to those with step 1 asthma in both univariate and multivariate analysis.ConclusionsAsthma led to poor outcomes of COVID-19; however, underlying asthma, use of asthma medication and asthma severity were not independent factors for poor clinical outcomes of COVID-19, generally.

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Epidemiological profile of asthmatic children in the wilaya of Sidi Bel Abbes: factors of asthma severity

Batna Journal of Medical Sciences (BJMS) ◽

10.48087/bjmsoa.2021.8105 ◽

2021 ◽

Vol 8 (1) ◽

pp. 24-29

Author(s):

Abdelkrim Messafeur ◽

◽

Nafissa Belkessam ◽

Keyword(s):

Nous Avons ◽

Santé Publique ◽

Asthma Severity ◽

Mots Clés ◽

Mode De Vie ◽

Asthmatic Children ◽

Global Initiative For Asthma ◽

Facteurs Environnementaux ◽

Global Initiative ◽

Epidemiological Profile

Introduction : L’asthme sévère est un réel problème de santé publique. Le but de notre travail est de mettre en évidence les facteurs influençant la sévérité de l’asthme chez la population jeune. Matériel et méthode : Il s’agit d’une enquête transversale concernant les enfants et adolescents asthmatiques scolarisés âgés de 6 à 19 ans et résidents dans la wilaya de Sidi-Bel-Abbès entre Janvier et Mars 2016. Le questionnaire utilisé reprend les critères d'évaluation du contrôle recommandés par le Global Initiative for Asthma (GINA) 2008. Résultats et discussion : Nous avons colligé 432 enfants et adolescents asthmatiques. La prévalence de l'asthme sévère est de 12,7% et est élevée par rapport à la prévalence de 4% retrouvée dans l’étude de Benallal en 2010 menée en milieu hospitalier. Une relation significative est notée entre la sévérité de l’asthme et le mode de vie urbain de notre population et presque les deux tiers des enfants et adolescents souffrant d’asthme sévère sont exposés au tabagisme passif. Une association très significative est remarquée entre la prévalence relative de l’asthme sévère et le rang dans la fratrie d’une part et la taille de fratrie d’autre part. Dans notre étude, la répartition en fonction du statut pondéral, montre que 22% de nos patients sont en surpoids ou obèses. L’obésité est associée à une inflammation systémique qui module l’inflammation des voies respiratoires et, par conséquent, l’expression de l’asthme chez les obèses. Conclusion : La sévérité de l’asthme peut être causée, déclenchée ou influencée par de nombreux facteurs environnementaux ou liés au patient lui-même. Mots clés : asthme sévère, facteurs influençant, tabagisme passif, obésité.

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The Quality of Life on Asthmatic Adolescent and Its Correlation with the Severity and Control of Asthma

Global Medical & Health Communication (GMHC) ◽

10.29313/gmhc.v8i1.5871 ◽

2020 ◽

Vol 8 (1) ◽

Author(s):

Lisa Adhia Garina ◽

Muhammad Ridho Grahadinta ◽

Ferry Achmad Firdaus Mansoer ◽

Intan Puspitasari

Keyword(s):

Quality Of Life ◽

Asthma Control ◽

Asthma Severity ◽

Control Test ◽

Asthma Control Test ◽

Cross Sectional ◽

Spearman's Rho ◽

Global Initiative For Asthma ◽

Global Initiative

Asthma is considered a global health problem that, if not managed properly, can reduce the sufferers' quality of life. The purpose of the study was to evaluate the quality of life from the perspectives of asthma severity and the asthma control level. A cross-sectional study was conducted from February to June 2018 on asthmatic adolescents aged 12–14 years old in two public junior high schools in Bandung city, Indonesia. The diagnosis, history of asthma, severity, and asthma control were established based on the National Asthma Guidelines from the Indonesian Pediatric Society, Global Initiative for Asthma (GINA), asthma control test (ACT), and ISAAC questionnaire. Statistical analysis performed using SPSS v.20 with Spearman's rho to determine the significance. The gender distribution of the 98 subjects was almost similar with slightly more girls (51%). The median age was 13±1 years with average ACT, FVC, and PAQLQ(S) total scores of 20±4, 78±16%, and 5.3±1.3, respectively. The domain scores for symptoms, activity limitations, and emotional function were 4.9±1.4, 5.0±1.3, and 5.7±1.1, respectively. There are correlations between the total PAQLQ(S) score and asthma severity (p<0.001, r=−0.5) and the level of asthma control (p<0.001, r=0.6). In summary, the quality of life has a relationship with asthma severity and the level of asthma control. Asthma management should not only focus on medication but also ways to maintain a good quality of life. KUALITAS HIDUP REMAJA ASMA DAN HUBUNGANNYA DENGAN KEKERAPAN GEJALA DAN DERAJAT KENDALI ASMAAsma masih menjadi masalah kesehatan penting yang jika tidak ditangani baik, asma dapat menurunkan kualitas hidup anak. Tujuan penelitian ini menilai kualitas hidup dan hubungannya dengan kekerapan gejala dan derajat kendali asma. Penelitian cross-sectional ini dilaksanakan dari bulan Februari hingga Juni 2018 pada remaja asma berusia 12–14 tahun di dua SMPN di Kota Bandung, Indonesia. Diagnosis, riwayat asma, kekerapan gejala, dan derajat kendali asma berdasar atas Pedoman Nasional Asma Anak Ikatan Dokter Anak Indonesia, Global Initiative for Asthma (GINA), asthma control test (ACT), dan kuesioner dari ISAAC. Analisis statistik menggunakan SPSS v.20 dengan uji Spearman’s rho untuk menentukan signifikansi. Distribusi gender dari 98 subjek penelitian hampir sama dengan sedikit lebih banyak perempuan (51%). Usia rerata subjek 13±1 tahun dengan skor rerata ACT, FVC, PAQLQ(S) masing-masing 20±4, 78±16%, dan 5,3±1,3. Skor domain gejala, keterbatasan beraktivitas, dan fungsi emosi masing-masing 4,9±1,4; 5,0±1,3; dan 5,7±1,1. Terdapat hubungan skor total PAQLQ(S) dengan kekerapan gejala (p<0,001; r=−0,5) dan dengan derajat kendali asma (p<0,001; r=0,6). Simpulan, kualitas hidup berhubungan dengan kekerapan gejala dan derajat kendali asma. Pengelolaan asma sebaiknya tidak hanya memperhatikan pengobatan, tetapi juga menjaga kualitas hidup yang baik.

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National Asthma Education and Prevention Program 2020 Guidelines: What’s Important for Primary Care

10.12788/jfp.0219 ◽

2021 ◽

Vol 70 (6 Supplement) ◽

Author(s):

Murphy

Keyword(s):

Primary Care ◽

Prevention Program ◽

Expert Panel ◽

Asthma Management ◽

Persistent Asthma ◽

Asthma Severity ◽

Asthma Education ◽

Global Initiative For Asthma ◽

Primary Care Clinicians ◽

Global Initiative

KEY TAKEAWAYS • The 2020 Focused Updates to the Asthma Management Guidelines: A Report from the National Asthma Education and Prevention Program Coordinating Committee Expert Panel Working Group provides updated recommendations for 6 topics related to the management of individuals with asthma. • The classification of asthma severity and asthma control, as well as the concept of utilizing a stepwise approach to pharmacologic treatment, were not updated from the Expert Panel Report 3, released in 2007. • However, important updates in preferred therapies for intermittent and persistent asthma at treatment steps 1 through 5 were suggested. • Recommendations regarding biologic therapy were not included in the 2020 update, as only evidence and US Food and Drug Administration approvals through October 2018 were considered. • The most recent 2021 Global Initiative for Asthma guidelines are not included in this review but can be used in a complementary manner to assist primary care clinicians to optimize decisions regarding the care of patients with asthma.

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Depression Levels Influence the Rate of Asthma Exacerbations in Females

Journal of Personalized Medicine ◽

10.3390/jpm11060586 ◽

2021 ◽

Vol 11 (6) ◽

pp. 586

Author(s):

Papaporfyriou Anastasia ◽

Tseliou Eleni ◽

Mizi Eleftheria ◽

Ntontsi Xenia ◽

Papathanasiou Eygenia ◽

...

Keyword(s):

Control Level ◽

Depression Scale ◽

Low Frequency ◽

Anxiety And Depression ◽

Asthmatic Patients ◽

Asthma Exacerbations ◽

Depression Subscale ◽

Global Initiative For Asthma ◽

Asthma Patients ◽

Global Initiative

Background: Anxiety and depression are common psychological disturbances among asthmatic patients. The aim of the present study is the assessment of anxiety and depression in asthmatic patients and their correlation with symptoms control level and number of exacerbations per year. Methods: One hundred patients with asthma diagnosis, according to the Global Initiative for Asthma (GINA), aged > 18 years old, having a stable disease, were included. Emotional status was evaluated using the Hospital Anxiety Depression Scale (HADS). Patients were followed up for a year to assess the number and severity of exacerbations. Results: Most of our patients were female (58%), middle-aged (mean = 54 ± 13), and married (81%), with low frequency of smoking habits (smokers, ex-smokers and non-smokers were 26%, 30% and 37%, respectively) and low levels of both anxiety and depression [median (interquartile range (IQR)) = 4(2) and median (IQR) = 4(2), respectively]. At the low and moderate level of the depression subscale, female patients experienced asthma exacerbations more frequently compared to male patients (adjusted Incidence Rate Ratio (aIRR) = 4.30; 95% Confidence Interval (CI): 1.94–9.53 and aIRR = 1.82; 95% CI: 1.07–3.13, respectively). Conclusions. Clinicians should evaluate asthma patients for depression, as gender differentially influences outcomes among those with low and moderate levels of depression, with female asthmatics presenting more frequent exacerbations.

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A real-life comparison of the Asthma Control Test and Global Initiative for Asthma asthma control grading

Annals of Allergy Asthma & Immunology ◽

10.1016/j.anai.2016.09.442 ◽

2016 ◽

Vol 117 (6) ◽

pp. 725-727 ◽

Cited By ~ 2

Author(s):

Giorgio Ciprandi ◽

Fabio Gallo ◽

Fabio L.M. Ricciardolo

Keyword(s):

Asthma Control ◽

Real Life ◽

Control Test ◽

Asthma Control Test ◽

Global Initiative For Asthma ◽

Global Initiative

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The relationship between BMI, leptin, leptin receptors (LepR) and Foxp3+ Tregs cells in women with asthma

Diagnostyka Laboratoryjna ◽

10.5604/01.3001.0008.2513 ◽

2016 ◽

Vol 51 (4) ◽

pp. 277-284

Author(s):

Łukasz Kraszula ◽

Makandjou-Ola Eusebio ◽

Anna Jasińska ◽

Maciej Kupczyk ◽

Piotr Kuna ◽

...

Keyword(s):

Severe Asthma ◽

Leptin Receptor ◽

Control Group ◽

Soluble Receptor ◽

Leptin Receptors ◽

Global Initiative For Asthma ◽

Moderate Disease ◽

Global Initiative ◽

And Control ◽

The Relationship

The aim of this study was evaluation whether there is an association between BMI, leptin and its soluble receptor, the expression of FoxP3 in CD4+ pTreg in women with severe asthma. Materials and methods. The study included thirty women with asthma: 17 patients with severe and 13 with mild-moderate disease. The control group comprised of 25 healthy women. Asthma was diagnosed in accordance with the Global Initiative For Asthma guidelines (GINA 2014). The phenotype of CD4+CD25highCD127lowFoxp3+CD152+ cells was evaluated by multicolor flow cytometry. The concentration of leptin and its soluble receptor were determined using an immunoenzymatic method (ELISA). Results. It has been shown significantly increased leptin concentration in the group of women with severe asthma compared with mild-moderate asthma and control group (p <0.05). The concentration of the leptin receptor significantly increased (p <0.05) in women with severe asthma compared with control group. There were no differences in percentage of CD4+FoxP3+ and CD4+CD25highCD127low- FoxP3+CD152+ subsets after leptin stimulation in all tested groups. Conclusions. Our results don’t confirm the direct effect of leptin on the CD4+ pTreg cells and the expression of FoxP3 in these cells, in tested groups.

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