Real-life association between inhaler technique, patient preference and asthma control in patients with uncontrolled asthma switched to budesonide/formoterol DuoResp® Spiromax® combination

2021 ◽  
pp. 1-10
Author(s):  
Nicolas Roche, ◽  
Bernard Aguilaniu, ◽  
Simon Paternotte, ◽  
Nathalie Dallery,
Keyword(s):  
Asthma Control ◽  
Patient Preference ◽  
Real Life ◽  
Inhaler Technique ◽  
Uncontrolled Asthma

Obstructive sleep apnea is a determinant of asthma control independent of smoking, reflux, and rhinitis

2021 ◽  
Vol 42 (1) ◽  
pp. e25-e29
Author(s):  
Dilber Özden Mat ◽  
Selma Firat ◽  
Kurtuluş Aksu ◽  
Funda Aksu ◽  
Sezgi Şahin Duyar
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Asthma Control ◽  
Inhaler Technique ◽  
Uncontrolled Asthma ◽  
Asthma Control Test ◽  
Asthma Symptoms ◽  
Obstructive Sleep ◽  
Control Asthma ◽  
Correct Technique

Background: Asthma control is defined as to what extent manifestations of asthma can be observed in a patient or have been reduced or removed by treatment. Regular use of asthma treatments, correct inhaler technique, adequate information provided about the patient's diseases and medicines, and patient‐clinician collaboration aid asthma control. Asthma shares risk factors and links in the pathogenesis with obstructive sleep apnea (OSA), and OSA may aggravate asthma symptoms. Objective: To assess the risk of OSA for asthma control. Methods: The study was carried out in subjects with asthma who were followed up at specific time points and who used asthma medication regularly and with an appropriate inhaler technique. An asthma control test and a questionnaire were used to determine the asthma control levels and OSA risk of the subjects. Results: With regard to the questionnaire scoring, 77 of 137 subjects with asthma had a low OSA risk and 60 had a high OSA risk. The proportion of the subjects with a high OSA risk (p < 0.001) and were smokers (p = 0.020) were significantly higher in the subjects with uncontrolled asthma than in those with controlled asthma. Logistic regression analysis showed that the variables that affect asthma control status were the risk of OSA and obesity. The subjects with a low OSA risk were more likely to have controlled asthma than those with a high OSA risk (odds ratio 7.896 [95% confidence interval, 2.902‐21.487]; p < 0.001). Conclusion: In the subjects with asthma and who adhered to therapy and used inhalers with the correct technique, a high risk of OSA was associated with poor control of their asthma. This association was independent of other factors, including rhinitis, gastroesophageal reflux, and smoking.

scholarly journals Is a low level of education a limiting factor for asthma control in a population with access to pulmonologists and to treatment?

2019 ◽  
Vol 45 (1) ◽  
Author(s):  
Cassia Caroline Emilio ◽  
Cintia Fernanda Bertagni Mingotti ◽  
Paula Regina Fiorin ◽  
Leydiane Araujo Lima ◽  
Raisa Lemos Muniz ◽  
...  
Keyword(s):  
Risk Factor ◽  
Asthma Control ◽  
Treatment Adherence ◽  
Limiting Factor ◽  
Inhaler Technique ◽  
Uncontrolled Asthma ◽  
Asthma Control Questionnaire ◽  
Level Of Education ◽  
Low Level ◽  
Asthma Symptoms

ABSTRACT Objective: To determine whether a low level of education is a risk factor for uncontrolled asthma in a population of patients who have access to pulmonologists and to treatment. Methods: This was a cross-sectional study involving outpatients > 10 years of age diagnosed with asthma who were followed by a pulmonologist for at least 3 months in the city of Jundiai, located in the state of São Paulo, Brazil. The patients completed a questionnaire specifically designed for this study, the 6-item Asthma Control Questionnaire (to assess the control of asthma symptoms), and a questionnaire designed to assess treatment adherence. Patients underwent spirometry, and patient inhaler technique was assessed. Results: 358 patients were enrolled in the study. Level of education was not considered a risk factor for uncontrolled asthma symptoms (OR = 0.99; 95% CI: 0.94-1.05), spirometry findings consistent with obstructive lung disease (OR = 1.00; 95% CI: 0.99-1.01), uncontrolled asthma (OR = 1.03; 95% CI: 0.95-1.10), or the need for moderate/high doses of inhaled medication (OR = 0.99; 95% CI: 0.94-1.06). The number of years of schooling was similar between the patients in whom treatment adherence was good and those in whom it was poor (p = 0.08), as well as between those who demonstrated proper inhaler technique and those who did not (p = 0.41). Conclusions: Among asthma patients with access to pulmonologists and to treatment, a low level of education does not appear to be a limiting factor for adequate asthma control.

scholarly journals Epidemiology of comorbidities and their association with asthma control

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Gábor Tomisa ◽  
Alpár Horváth ◽  
Balázs Sánta ◽  
András Keglevich ◽  
Lilla Tamási
Keyword(s):  
Asthma Control ◽  
Smoking Status ◽  
Real Life ◽  
Patient Characteristics ◽  
Control Measures ◽  
Chronic Obstructive ◽  
Age Group ◽  
Uncontrolled Asthma ◽  
Asthmatic Patients ◽  
Binomial Regression

Abstract Background The prevalence of comorbidities and their relation to asthma control and treatment is a topic of increasing interest, however comprehensive studies are scarce. We aimed to determine the prevalence of the most common comorbidities in asthma in relation to patient characteristics (age, gender and body mass index [BMI]) and their association with asthma control in a large, specialist-managed representative patient population. Methods A secondary, exploratory analysis of the Asthma Reality (ARL), across-sectional, non-interventional real-life study was conducted. Basic patient characteristics, the prevalence of comorbidities and data on asthma control and risk factors had been collected and their interactions examined. Descriptive statistics and binomial regression were used to assess the distribution of the prevalence of comorbidities and propensity matching was applied to assess their effect on asthma control. Results Overall, 12,743 patients were enrolled in our study in 187 treatment centres covering all regions of Hungary. Most comorbidities showed significantly different distribution for all basic patient characteristics. Gender, age group, smoking status, BMI and the duration of asthma had a significant impact on asthma control. The frequency of uncontrolled asthma was higher in females (37.1%), in the age group of 46–65 years (39.6%), in severely obese patients (43.2%), in patients who had been diagnosed with asthma for more than 20 years (40.4%), and in active heavy smokers (55%), compared with respective groups in the same category. Based on the binomial regression with propensity score matching, concomitant chronic obstructive pulmonary disease (COPD) (odds ratio [OR] = 2.06, 95% confidence interval [CI] 1.80–2.36), ischaemic heart disease (OR = 1.86, 95% CI 1.64–2.10) and cerebrovascular events (OR = 1.85, 95% CI 1.47–2.32) had the strongest negative effect on asthma control, with the presence of all of these conditions increasing the risk of uncontrolled asthma. Conclusions This evaluation of comorbidity data of more than 12,000, adult asthmatic patients has provided a clearer picture of diseases that can frequently co-exist with asthma, and their influence on asthma control, assessed by the prevalence of symptoms. Our study suggests that most asthmatic patients have at least one comorbidity, and the presence of comorbidities may have a high impact on asthma control measures.

scholarly journals Asthma knowledge, care, and outcome during pregnancy: The QAKCOP study

2018 ◽  
Vol 16 ◽  
pp. 147997231876771 ◽  
Author(s):  
Wanis H Ibrahim ◽  
Fatima Rasul ◽  
Mushtaq Ahmad ◽  
Abeer S Bajwa ◽  
Laith I Alamlih ◽  
...  
Keyword(s):  
Health Care ◽  
Asthma Control ◽  
Inhaled Corticosteroids ◽  
Medical Condition ◽  
Action Plan ◽  
Well Being ◽  
Chronic Medical Condition ◽  
Uncontrolled Asthma ◽  
Asthma Care ◽  
In Pregnancy

Asthma is the most common chronic medical condition affecting pregnancy. Optimizing asthma management in pregnancy is paramount for the well-being of both the mother and the baby. The primary objectives of this study were to assess patient’s knowledge about asthma, the level of asthma care, and fetal and maternal outcomes among pregnant asthmatic women in this wealthy country with tremendous improvement in maternal and fetal health care. The secondary objective was to identify barriers to asthma control. This was a cross-sectional, face-to-face, prospective study of 80 pregnant women with physician-diagnosed asthma. About 56% of patients reported worsening of their asthma control during pregnancy, of which 52.3% felt this worsening in the third trimester. About 65% of patients had uncontrolled asthma during their pregnancy, and inhaler technique was incorrect in 64.4%. Only 38% of patients knew the difference between controller and reliever asthma medications, 12.7% of patients had received written asthma action plan, 17% had a spirometry done in the previous 5 years, and 3.8% had peak expiratory flow meter at home. The main reasons for uncontrolled asthma were lack of knowledge about right asthma medications in 30% and fear of side effects of inhaled corticosteroids in 19% of patients. No financial reason was reported. Significant associations between total number of pregnancies, poor perception of asthma medications, asthma exacerbation during delivery and poor asthma control were observed. Preeclampsia and congenital anomalies occurred at higher rates than previously reported among general population in this country. The tremendous improvements in maternal health care and socioeconomic status do not seem to be a barrier to the globally recognized poor asthma care in pregnancy. Important strategies are much needed.

Identification of asthma phenotypes based on extrapulmonary treatable traits

2020 ◽  
pp. 2000240 ◽  
Author(s):  
Patricia Duarte Freitas ◽  
Rafaella França Xavier ◽  
Vanessa Marie McDonald ◽  
Peter Gerard Gibson ◽  
Laura Cordova-Rivera ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cluster Analysis ◽  
Health Status ◽  
Asthma Control ◽  
Severe Asthma ◽  
Sedentary Time ◽  
Depression Symptoms ◽  
Uncontrolled Asthma ◽  
Asthma Phenotypes ◽  
Physically Inactive

BackgroundAsthma is a heterogeneous and complex disease, and the description of asthma phenotypes based on extrapulmonary treatable traits has not been previously reported.Objectiveto identify and characterise clusters based on clinical, functional, anthropometrical, and psychological characteristics in participants with moderate-to-severe asthma.MethodsThis is a cross-sectional multicentre study involving centres from Brazil and Australia. Participants (N=296) with moderate-to-severe asthma were consecutively recruited. Physical activity and sedentary time, clinical asthma control, anthropometric data, pulmonary function, psychological, and health-status were evaluated. Participants were classified by hierarchical cluster analysis and the clusters compared using ANOVA, Kruskal-Wallis, and Chi-square tests. Multiple logistic and linear regression models were performed to evaluate the association between variables.ResultsWe identified four clusters: (1)controlled asthma who were physically active, (2)uncontrolled asthma who were physically inactive and more sedentary, (3)uncontrolled asthma with low physical activity, who were also obese and experienced anxiety and/or depression symptoms (4)very uncontrolled asthma, who were physically inactive, more sedentary, obese and experienced anxiety and/or depression symptoms. Higher levels of sedentary time, female sex, and anxiety symptoms were associated with increased odds of exacerbation risk while being more active showed a protective factor for hospitalisation. Asthma control was associated with sex, the occurrence of exacerbation, physical activity, and health-status.ConclusionTraits such as physical inactivity, obesity, and symptoms of anxiety and/or depression were associated with worse asthma outcomes, and closely and inextricably with asthma control. This cluster analysis supports the importance of assessing extrapulmonary traits to improve personalised management and outcomes for people with moderate and severe asthma.

scholarly journals Assessment of disease control in patients with asthma

Medicina ◽  
2009 ◽  
Vol 45 (12) ◽  
pp. 943 ◽  
Author(s):  
Guoda Pilkauskaitė ◽  
Kęstutis Malakauskas ◽  
Raimundas Sakalauskas
Keyword(s):  
Lung Function ◽  
Asthma Control ◽  
Control Level ◽  
Asthma Management ◽  
Control Test ◽  
Uncontrolled Asthma ◽  
Asthma Control Test ◽  
Inhaled Steroids ◽  
Asthma Patients ◽  
Β2 Agonists

International guidelines indicate that the main criterion of asthma management is asthma control level. The aim of this study was to assess asthma control and its relation with age, gender, and lung function. Material and methods. A total of 106 family physicians and 13 pulmonologists and allergists took part in this study. Each doctor had selected 10–15 asthma patients and had sent invitations to them by post. On the visit day, the patients themselves filled in the Asthma Control Test. The doctors interviewed the patients and filled in a special questionnaire. Pulmonologists and allergists also assessed lung function by performing spirometry. According to the results of the Asthma Control Test, the disease control level was indicated as “totally controlled” (25 points), “well controlled” (24–20 points), and “uncontrolled” (19 points or less). Results. A total of 876 asthma patients were examined. Uncontrolled asthma was diagnosed to 56.2% of the patients, 36.5% of patients had well controlled and 7.3% totally controlled asthma. There was no significant difference in asthma control level comparing men and women. A correlation between asthma control level and age was found revealing poorer asthma control in older patients. Ninety-five percent of patients were treated with inhaled steroids; most of them had used inhaled steroids in combination with long-acting β2 agonists. It was found that lung function correlated with clinical symptoms of asthma, the demand of shortacting β2 agonists, and asthma control level. Conclusion. The study showed that uncontrolled asthma was diagnosed to more than half of the patients, despite most of them used inhaled steroids. Asthma control was worsening with the age of patients with asthma and it correlated with lung function. We suggest that periodical assessment of asthma control should help to optimize asthma management.

scholarly journals Control of asthma in real life: still a valuable goal?

2015 ◽  
Vol 24 (136) ◽  
pp. 361-369 ◽  
Author(s):  
Andriana I. Papaioannou ◽  
Konstantinos Kostikas ◽  
Eleftherios Zervas ◽  
Lykourgos Kolilekas ◽  
Spiridon Papiris ◽  
...  
Keyword(s):  
Patient Education ◽  
Asthma Control ◽  
Healthcare Professionals ◽  
Real Life ◽  
Adherence To Treatment ◽  
Concerted Action ◽  
Good Patient ◽  
Asthma Patients ◽  
Refractory Asthma

Although studies show that control of asthma can be achieved in the majority of patients, surveys repeatedly show that this is not the case in real life. Important measures to implement in order to achieve asthma control are trained healthcare professionals, a good patient–doctor relationship, patient education, avoidance of exposure to triggers, personalised management and adherence to treatment. These measures help the majority of asthma patients but have not yet been widely implemented and there should be a concerted action for their implementation. Moreover, further and focused research is needed in severe/refractory asthma.

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