Wirksamkeit von Disease-Management-Programmen für Asthma und COPD? Ergebnisse einer Querschnittstudie

Pneumologie ◽  
2020 ◽  
Vol 74 (03) ◽  
pp. 174-182
Author(s):  
F. Kanniess ◽  
K. Krockenberger ◽  
P. Oepen ◽  
R. Hedrich ◽  
D. Olbrich ◽  
...  
Keyword(s):  
Disease Management ◽  
Asthma Control ◽  
Disease Management Programme ◽  
Management Programme ◽  
Randomisierte Studien ◽  
Control Test ◽  
Asthma Control Test ◽  
Fand Sich ◽  
Copd Assessment Test ◽  
Act Score

Zusammenfassung Einleitung Die Wirksamkeit der deutschen Disease-Management-Programme (DMP) Asthma und chronisch obstruktive Lungenerkrankung (COPD) kann mit den gesetzlich vorgeschriebenen Dokumentationen nicht gezeigt werden. Studien mit Vergleichsgruppen sind selten. Ziel war es, in einer Querschnittstudie zu untersuchen, ob sich die Krankheitskontrolle bei Teilnehmern (DMP+) und Nicht-Teilnehmern (DMP–) der DMP Asthma und COPD voneinander unterscheidet. Methoden Die Studie ist eine prospektive, multizentrische Querschnittstudie, die untersucht, inwieweit DMP+-Patienten sich von entsprechenden DMP–-Patienten im Hinblick auf ihre Krankheitskontrolle voneinander unterscheiden. Primärer Endpunkt war die Krankheitskontrolle, gemessen mit dem Asthma-Control-Test™ (ACT) im Studienteil Asthma sowie dem COPD-Assessment-Test™ (CAT) im Studienteil COPD. Ergebnisse Insgesamt wurden 1038 Asthma-Patienten und 846 COPD-Patienten eingeschlossen, je mit etwa 70 % DMP-Teilnehmern. Der ACT-Score war bei den Asthma-DMP+-Patienten höher als bei den DMP– -Patienten (Mittelwertdifferenz 0,86; 95 % KI: 0,29 – 1,43; p = 0,003), allerdings klinisch nicht relevant. Bei COPD-Patienten fand sich ebenfalls kein klinisch relevanter Unterschied in der Krankheitskontrolle (0,52; 95 % KI: – 0,71 – 1,75; p = 0,405). Nur etwa 60 % der Patienten, die seit mindestens einem Jahr in das entsprechende DMP eingeschrieben waren, hatten an einer strukturierten Schulung teilgenommen. Zwischen geschulten und nicht geschulten Patienten fand sich kein Unterschied in der Krankheitskontrolle. Diskussion Es fand sich kein klinisch relevanter Unterschied in der Krankheitskontrolle zwischen DMP+ - und DMP– -Patienten für die DMP Asthma und COPD. International wurde die Wirksamkeit von DMP bei Asthma und COPD in randomisierten Studien nachgewiesen. Auch in Deutschland sollten randomisierte Studien durchgeführt werden, um die Wirksamkeit der DMP Asthma und COPD zu belegen. Registrierung drks.de, DRKS00007664, Registrierungsdatum: 15.01.2015

Wirksamkeit von Disease-Management-Programmen für Asthma und COPD? Ergebnisse einer Querschnittstudie

2018 ◽  
Vol 144 (02) ◽  
pp. e12-e20
Author(s):  
Frank Kanniess ◽  
Katja Krockenberger ◽  
Petra Oepen ◽  
Rahel Hedrich ◽  
Denise Olbrich ◽  
...  
Keyword(s):  
Disease Management ◽  
Asthma Control ◽  
Disease Management Programme ◽  
Management Programme ◽  
Randomisierte Studien ◽  
Control Test ◽  
Asthma Control Test ◽  
Fand Sich ◽  
Copd Assessment Test ◽  
Act Score

Zusammenfassung Einleitung Die Wirksamkeit der deutschen Disease-Management-Programme (DMP) Asthma und chronisch obstruktive Lungenerkrankung (COPD) kann mit den gesetzlich vorgeschriebenen Dokumentationen nicht gezeigt werden. Studien mit Vergleichsgruppen sind selten. Ziel war es, in einer Querschnittstudie zu untersuchen, ob sich die Krankheitskontrolle bei Teilnehmern (DMP+) und Nicht-Teilnehmern (DMP–) der DMP Asthma und COPD voneinander unterscheidet. Methoden Die Studie ist eine prospektive, multizentrische Querschnittstudie, die untersucht, inwieweit DMP+-Patienten sich von entsprechenden DMP–-Patienten im Hinblick auf ihre Krankheitskontrolle voneinander unterscheiden. Primärer Endpunkt war die Krankheitskontrolle, gemessen mit dem Asthma-Control-Test™ (ACT) im Studienteil Asthma sowie dem COPD-Assessment-Test™ (CAT) im Studienteil COPD. Ergebnisse Insgesamt wurden 1038 Asthma-Patienten und 846 COPD-Patienten eingeschlossen, je mit etwa 70 % DMP-Teilnehmern. Der ACT-Score war bei den Asthma-DMP+-Patienten höher als bei den DMP–-Patienten (Mittelwertdifferenz 0,86; 95 %KI: 0,29 – 1,43; p = 0,003), allerdings klinisch nicht relevant. Bei COPD-Patienten fand sich ebenfalls kein klinisch relevanter Unterschied in der Krankheitskontrolle (0,52; 95 %KI: -0,71 – 1,75; p = 0,405). Nur etwa 60 % der Patienten, die seit mindestens einem Jahr in das entsprechende DMP eingeschrieben waren, hatten an einer strukturierten Schulung teilgenommen. Zwischen geschulten und nicht geschulten Patienten fand sich kein Unterschied in der Krankheitskontrolle. Diskussion Es fand sich kein klinisch relevanter Unterschied in der Krankheitskontrolle zwischen DMP+- und DMP–-Patienten für die DMP Asthma und COPD. International wurde die Wirksamkeit von DMP bei Asthma und COPD in randomisierten Studien nachgewiesen. Auch in Deutschland sollten randomisierte Studien durchgeführt werden, um die Wirksamkeit der DMP Asthma und COPD zu belegen. Registrierung drks.de, DRKS00007664, Registrierungsdatum: 15.01.2015

scholarly journals Hubungan Kadar Periostin Serum dan Nilai Asthma Control Test pada Pasien Asma di RSUD Dr. Soetomo Surabaya

2018 ◽  
Vol 4 (2) ◽  
pp. 33
Author(s):  
Ni Made Dwita Yaniswari ◽  
Muhammad Amin
Keyword(s):  
Asthma Control ◽  
Matrix Protein ◽  
Extracellular Matrix Protein ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Test ◽  
Uncontrolled Asthma ◽  
Asthma Control Test ◽  
Asthmatic Patients ◽  
Act Score ◽  
Serum Periostin

Background: Asthma is a heterogenous disease composed of various phenotype. Chronic airway inflammation are fundamental features of asthma. The main treatment of asthma is corticosteroid. The administration of inhaled corticosteroids will reduce the inflammatory process in asthma. Even with adequate inhaled corticosteroid treatment, there are still patients who develop symptoms with lower asthma control test score. Periostin is an extracellular matrix protein as the best single systemic biomarker for assessing tissue eosinophilia, airway remodeling in uncontrolled asthma. The objective of this study was to examine whether serum periostin is correlated with ACT in asthmatic patients. Methods: This research was an observational analytical with cross sectional design conducted in outpatient clinic Dr. Soetomo General Hospital Surabaya for 3 months. In total, we found 40 asthmatic patients who were qualified to the inclusion and exclusion criteria as the research samples.  The questionnaire was filled in to assess the Asthma Control Test and venous blood tests to measure serum periostin levels using Sandwich Enzyme-Linked Immunosorbent Assay (ELISA) method. Results: The mean periostin level profile of the sample was 94.82 ± 19.21 ng/ml and the median was 94.7 ng/ml. The average ACT score was 16.55 ± 2.93 with 85% were uncontrolled asthma. The results of the independent t-test showed serum periostin levels and the level of asthma control based on ACT score in asthmatics patients had a significant correlation (p = 0.024). Conclusion: There is a significant correlation between serum periostin levels and ACT score in asthmatic patients.

scholarly journals Pengaruh Teknik Pernapasan Buteyko terhadap ACT

2018 ◽  
Vol 1 (2) ◽  
pp. 47-61
Author(s):  
Marlin Sutrisna ◽  
Emmy H Pranggono ◽  
Titis Kurniawan
Keyword(s):  
Asthma Control ◽  
Control Test ◽  
Act Scores ◽  
Asthma Control Test ◽  
Group Design ◽  
Post Test ◽  
Quasi Experimental ◽  
Act Score ◽  
Post Hoc ◽  
Better Than

This study aims to determine the effect of buteyko breathing technique on asthma control test.The quasi experimental study with the pretest and post test one group design approach involved 14 patients with asthma selected from the Lung Polyclinic of Dr. Hasan Sadikin Bandung with consecutive sampling. Asthma control was collected using time series ACT. The collected data were analyzed descriptively and inferentially with the scale of significance p smaller than 0.05.The results showed a significantly higher mean difference between ACT scores after buteyko breathing technique 19.79 more or less 1.47 with ACT score at week III 17.50 moe or less 1.78 week II 12.64 more or less 1.82, week I 9.57 more or less 1.95, and pretest 7.64 more or less 1.82. Post hoc analysis found the fourth week post test score 19.79 more or less 1.47 significantly better than post test week III 17.50 more or less 1.78, week II 12.64 more or less 1.82, week I 9.57 more or less 1.95, and pretest 7.64 more or less 1.82 in improving asthma control. It was concluded that there was an effect of buteyko breathing technique on asthma control test. Thus, the results of this study become important as a study material for nurses at the Hospital in an effort to increase asthma control test. Keywords: ACT, Breathing Technique, Bronchial Asthma, Buteyko  

scholarly journals Novel pharmacist-led intervention secures the minimally important difference (MID) in Asthma Control Test (ACT) score: better outcomes for patients and the healthcare provider

2018 ◽  
Vol 5 (1) ◽  
pp. e000322
Author(s):  
Michela Tinelli ◽  
John White ◽  
Andrea Manfrin
Keyword(s):  
Asthma Control ◽  
Controlled Trial ◽  
Cluster Randomised Controlled Trial ◽  
Published Data ◽  
Minimally Important Difference ◽  
Control Test ◽  
Traffic Light ◽  
Asthma Control Test ◽  
Life Years ◽  
Act Score

IntroductionA key priority in asthma management is achieving control. The Asthma Control Test (ACT) is a validated tool showing a numerical indicator which has the potential to provide a target to drive management. A novel pharmacist-led intervention recently evaluated and introduced in the Italian setting with a cluster randomised controlled trial (C-RCT) showed effectiveness and cost-effectiveness. This paper evaluates whether the intervention is successful in securing the minimally important difference (MID) in the ACT score and provides better health outcomes and economic savings.MethodsClinical data were sourced from 816 adult patients with asthma participating in the C-RCT. The success of the intervention was measured looking at the proportion of patients reaching MID in the ACT score. Different levels of asthma control were grouped according to international guidelines and graded using the traffic light rating system. Asthma control levels were linked to economic (National Health Service (NHS) costs) and quality-adjusted life years outcomes using published data.ResultsThe median ACT score was 19 (partially controlled) at baseline, and 20 and 21 (controlled) at 3-month and 6-month-follow up, respectively (p<0.01). The percentage of patients reaching MID at 3 and 6 months was 15.8% (129) and 19.9% (162), respectively. The overall annual NHS cost savings per 1000 patients attached to the shift towards the MID target were equal to €346 012 at 3 months and increased to €425 483 at 6 months. Health utility gains were equal to 35.42 and 45.12 years in full health gained, respectively.DiscussionThe pharmacist-led intervention secured the MID in the ACT score and provided better outcomes for both patients and providers.

scholarly journals Validation of the Serbian version of the Asthma Control Test

2019 ◽  
Vol 76 (10) ◽  
pp. 1029-1036
Author(s):  
Branislava Milenkovic ◽  
Snezana Ristic ◽  
Danijela Mirovic ◽  
Sanja Dimic-Janjic ◽  
Jelena Jankovic ◽  
...  
Keyword(s):  
Asthma Control ◽  
Chronic Respiratory Disease ◽  
Acute Respiratory Tract Infection ◽  
Forced Expiratory Volume ◽  
Control Test ◽  
Asthma Control Test ◽  
Asthmatic Patients ◽  
Serbian Version ◽  
Act Score ◽  
Act Test

Background/Aim. Asthma still remains poorly controlled in the majority of patients. The Asthma Control Test (ACT) is a short and useful patient-administered questionnaire for identification of patients with poor asthma control in clinical settings. The aim of this study was to validate a Serbian version of the ACT in the adults with asthma. Methods. A total of 250 consecutive adult asthmatic patients were recruited in a prospective observational study. The exclusion criteria were chronic respiratory disease and acute respiratory tract infection in preceding 4 weeks. Results. The spirometry and ACT questionnaire were performed on the baseline visit and 6 months later. The ACT test was completed by 98.8% of patients with the mean time of completion of 4.5 minutes. The correlation of ACT score and lung function parameters (forced expiratory volume in 1 second ? FEV1 and forced vital capacity ? FVC) was significant (p = 0.016 and p = 0.002, respectively). A change in the ACT scores between baseline and 6- months visit was not associated with a change in FVC and FEV1. The ACT score had excellent diagnostic accuracy according to the physicians asthma control classification and even outstanding accuracy according to the patients? classification. Conclusion. The results of this study confirm the reliability, validity and accuracy of Serbian version of the ACT, contributing to established value of original ACT test and with consistent findings as the previously reported validity of ACT in other languages. Therefore, it should be utilized more in everyday clinical practice as a useful and reliable tool of asthma control assessment.

High-Risk Asthma Multidisciplinary Care Clinic Adherence Linked To Asthma Control Test (ACT) Score Improvement

2014 ◽  
Vol 133 (2) ◽  
pp. AB155
Author(s):  
Bradley A. Locke ◽  
Pippa Simpson ◽  
Tina Bromberger ◽  
Melodee Nugent ◽  
Sara A. Lowe ◽  
...  
Keyword(s):  
High Risk ◽  
Asthma Control ◽  
Multidisciplinary Care ◽  
Control Test ◽  
Asthma Control Test ◽  
Care Clinic ◽  
Score Improvement ◽  
Act Score

scholarly journals The Asthma Control Test (ACT) as Predictor of Asthma Exacerbation among Indonesian Hajj Pilgrims in 2018

2020 ◽  
Vol 4 (2) ◽  
pp. 128
Author(s):  
Saifuddin A ◽  
Zaini Nasir U ◽  
Rengganis I
Keyword(s):  
Asthma Control ◽  
Asthma Exacerbation ◽  
Area Under The Curve ◽  
Control Test ◽  
Act Scores ◽  
Asthma Control Test ◽  
Asthma Exacerbations ◽  
Acute Asthma Exacerbation ◽  
Act Assessment ◽  
Act Score

Objective: Every year, millions of Muslims from around the world gather in Saudi Arabia to perform Hajj. Before leaving for pilgrimage, Indonesian pilgrims go through various health examinations in Regional Primary Health Center (Pusat Kesehatan Masyarakat/ Puskesmas). Since there was no existing research on Asthma Control Test (ACT) assessment for pilgrims with bronchial asthma to predict asthma exacerbations during Hajj pilgrimage period, this cohort study was conducted to fill this gap.Methods: Pilgrims who suffered from asthma were recruited in Daerah Khusus Ibukota (DKI) Jakarta Province region in 2018. The degree classification of asthma in the ACT group was determined as uncontrolled, partially controlled, and fully controlled. ACT scores were calculated in Puskesmas and embarkation. Observation of asthma exacerbations in pilgrims while performing Hajj was performed by doctors. Data were analyzed with SPSS for Windows.Results: A total of 68 participants were included (46 female [67.6%]; 45 aged <60 years [66.2%]). At embarkation, the asthma classification based on the ACT was as follows: 36 (52.9%) and 13 (19.1%) pilgrims had partially controlled and uncontrolled asthma, and 17 (47.2%) and 8 (61.5%) of each group experienced exacerbation, respectively, with p = 0.006 for the ACT values at embarkation. The area under the curve value was 0.717 (95% CI; 0.596-0.838).Conclusion: There was increased asthma exacerbation incidence in the uncontrolled and partially controlled ACT groups at embarkation compared to the fully controlled ACT group. The ACT score was able to predict the occurrence of acute asthma exacerbation during Hajj period.International Journal of Human and Health Sciences Vol. 04 No. 02 April’20 Page : 128-135

Sign in / Sign up

Export Citation Format

Share Document