Pharmacist Led Intervention on Inhalation Technique among Asthmatic Patients for Improving Quality of Life in a Private Hospital of Nepal

Purpose. Asthma is a chronic disease which cannot be cured but can be controlled. Although drug therapy is used to relieve and prevent symptoms of asthma and treat exacerbations, still a good asthma control and a better quality of life in many patients is suboptimal due to improper use of inhalation technique. Thus, this interventional study was conducted to evaluate the effect of a pharmacist intervention on asthma control, quality of life and inhaler technique in adult asthmatic patients. Patients and Methods. A total of 72 patients who met the inclusion criteria and agreed to give written consent were enrolled in the study. These patients were randomly divided into two groups i.e., test group (36) and control group (36) by simple block randomization technique. Test group were the interventional groups. Mini Asthma Quality of Life Questionnaire (AQLQ), Asthma Control Questionnaire (ACQ) and structured questionnaires were used to sort the information like quality of life, asthma control and demographic details. They were counselled by the pharmacist about the asthma management and proper use of inhalers. Out of 72 patients, only forty six patients came for follow up after one month. Data were entered and analyzed using Statistical Package for Social Sciences (SPSS) software version 20. Results. A significant change was observed in the mean score of quality of life (p=0.001) in test group as well as control group, however change in the mean score of asthma control in the test group (p=0.001) was more significant as compared to the control group (p=0.099). Inhalation technique was found to be improved significantly after intervention among patients using the metered dose inhaler and dry powder inhaler. Majority of the patients were prescribed with Methylxanthines (24.5%) followed by combined Beta 2 agonists and Inhaled Corticosteroids (21.7%). Conclusion. Pharmacist provided intervention improves the quality of life, asthma control and inhalation technique among asthmatic patients.

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Clinical, functional and inflammatory evaluation in asthmatic patients after a simple short-term educational program: a randomized trial

10.21203/rs.3.rs-403514/v1 ◽

2021 ◽

Author(s):

Soraia Nogueira Felix ◽

Rosana Camara Agondi ◽

Marcelo Vivolo Aun ◽

Clarice Rosa Olivo ◽

Francine Maria de Almeida ◽

...

Keyword(s):

Quality Of Life ◽

Asthma Control ◽

Educational Intervention ◽

Intervention Group ◽

Educational Activity ◽

Control Group ◽

Life Questionnaire ◽

Asthmatic Patients ◽

Quality Life

Abstract This study aimed to evaluate the clinical evolution, functional parameters and inflammatory activity of asthma in patients who submitted to an educational intervention. 58 adult patients over 18 years of age with partly controlled and uncontrolled asthma were randomized into an intervention group (IG) (N = 32) and a control group (CG) (N = 26) and evaluated for 12 weeks. The Asthma Control Test (ACT), Asthma Control Questionnaire (ACQ), Asthma Quality Life Questionnaire (AQLQ) and Beck Depression Inventory (BDI) questionnaires were applied. Spirometry, exhaled nitric oxide (NO), exhaled breath condensate (EBC) and induced sputum (IS), measurement of the peak flow and symptoms were performed. The IG patients received an educational activity for 30 minutes applied by a nurse. Statistical analysis: analysis of variance with repeated intragroup measures. IG presented a decreased number of eosinophils in IS and IL-17A in EBC, an increase in the percentage of FEV1 after bronchodilatation and an improvement in quality of life compared to the CG. There was an improvement in depression levels and a decrease in IL-4 and IL-5 in the IS and in the EBC in the IG compared to the CG. Our results suggest that an educational intervention can bring benefits concerning the control of inflammation, lung function alterations, quality of life and levels of depression in asthmatic patients. Registration: ClinicalTrials.gov; NCT03655392.

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Clinical, functional and inflammatory evaluation in asthmatic patients after a simple short-term educational program: a randomized trial

Scientific Reports ◽

10.1038/s41598-021-97846-8 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Soraia Nogueira Felix ◽

Rosana Câmara Agondi ◽

Marcelo Vivolo Aun ◽

Clarice Rosa Olivo ◽

Francine Maria de Almeida ◽

...

Keyword(s):

Quality Of Life ◽

Asthma Control ◽

Educational Intervention ◽

Intervention Group ◽

Educational Activity ◽

Control Group ◽

Life Questionnaire ◽

Asthmatic Patients ◽

Quality Life

AbstractThis study aimed to evaluate the clinical evolution, functional parameters and inflammatory activity of asthma in patients who submitted to an educational intervention. 58 adult patients over 18 years of age with partly controlled and uncontrolled asthma were randomized into an intervention group (IG) (N = 32) and a control group (CG) (N = 26) and evaluated for 12 weeks. The Asthma Control Test (ACT), Asthma Control Questionnaire (ACQ), Asthma Quality Life Questionnaire (AQLQ) and Beck Depression Inventory (BDI) questionnaires were applied. Spirometry, exhaled nitric oxide (NO), exhaled breath condensate (EBC) and induced sputum (IS), measurement of the peak flow and symptoms were performed. The IG patients received an educational activity for 30 min applied by a nurse. Statistical analysis: analysis of variance with repeated intragroup measures. IG presented a decreased number of eosinophils in IS and IL-17A in EBC, an increase in the percentage of FEV1 before and after bronchodilator and an improvement in quality of life compared to the CG. There was an improvement in depression levels and a decrease in IL-4 and IL-5 in the IS and in the EBC in both groups. Our results suggest that an educational intervention can bring benefits concerning the control of inflammation, lung function alterations, quality of life and levels of depression in asthmatic patients. Registration: ClinicalTrials.gov; NCT03655392.

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Fatigue is Highly Prevalent in Patients with Asthma and Contributes to the Burden of Disease

Journal of Clinical Medicine ◽

10.3390/jcm7120471 ◽

2018 ◽

Vol 7 (12) ◽

pp. 471 ◽

Cited By ~ 10

Author(s):

Maarten Van Herck ◽

Martijn Spruit ◽

Chris Burtin ◽

Remco Djamin ◽

Jeanine Antons ◽

...

Keyword(s):

Quality Of Life ◽

Asthma Control ◽

Global Strategy ◽

Airflow Limitation ◽

Stepwise Multiple Regression ◽

Life Questionnaire ◽

Exacerbation Rate ◽

Asthmatic Patients ◽

Severe Fatigue

The 2018 update of the Global Strategy for Asthma Management and Prevention does not mention fatigue-related symptoms. Nevertheless, patients with asthma frequently report tiredness, lack of energy, and daytime sleepiness. Quantitative research regarding the prevalence of fatigue in asthmatic patients is lacking. This retrospective cross-sectional study of outpatients with asthma upon referral to a chest physician assessed fatigue (Checklist Individual Strength-Fatigue (CIS-Fatigue)), lung function (spirometry), asthma control (Asthma Control Questionnaire (ACQ)), dyspnea (Medical Research Council (MRC) scale), exercise capacity (six-minute walk test (6MWT)), and asthma-related Quality-of-Life (QoL), Asthma Quality of Life Questionnaire (AQLQ) during a comprehensive health-status assessment. In total, 733 asthmatic patients were eligible and analyzed (47.4 ± 16.3 years, 41.1% male). Severe fatigue (CIS-Fatigue ≥ 36 points) was detected in 62.6% of patients. Fatigue was not related to airflow limitation (FEV1, ρ = −0.083); was related moderately to ACQ (ρ = 0.455), AQLQ (ρ = −0.554), and MRC (ρ = 0.435; all p-values < 0.001); and was related weakly to 6MWT (ρ = −0.243, p < 0.001). In stepwise multiple regression analysis, 28.9% of variance in fatigue was explained by ACQ (21.0%), MRC (6.5%), and age (1.4%). As for AQLQ, 42.2% of variance was explained by fatigue (29.8%), MRC (8.6%), exacerbation rate (2.6%), and age (1.2%). Severe fatigue is highly prevalent in asthmatic patients; it is an important determinant of disease-specific QoL and a crucial yet ignored patient-related outcome in patients with asthma.

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Effect of vitamin D supplementation on asthma control in patients with vitamin D deficiency: the ACVID randomised clinical trial

Thorax ◽

10.1136/thoraxjnl-2019-213936 ◽

2020 ◽

pp. thoraxjnl-2019-213936

Author(s):

Rubén Andújar-Espinosa ◽

Lourdes Salinero-González ◽

Fátima Illán-Gómez ◽

Manuel Castilla-Martínez ◽

Chunshao Hu-Yang ◽

...

Keyword(s):

Quality Of Life ◽

Vitamin D ◽

Vitamin D Deficiency ◽

Asthma Control ◽

Intervention Group ◽

Vitamin D Supplementation ◽

Control Group ◽

Asthmatic Patients ◽

Secondary Endpoints

BackgroundThe relationship between asthma and vitamin D deficiency has been known for some time. However, interventional studies conducted in this regard have shown conflicting results.ObjectiveTo evaluate the efficacy of vitamin D supplementation in asthmatic patients in improving the degree of control of asthma.MethodsRandomised, triple-blind, placebo-controlled, parallel-group study in adult asthmatic patients with serum 25-hydroxyvitamin-D3 <30 ng/mL. The intervention group received oral supplementation with 16 000 IU of calcifediol per week, and the control group had placebo added to their usual asthma treatment. The study period was 6 months. The primary endpoint was the degree of asthma control as determined by the asthma control test (ACT). Secondary endpoints included quality of life measured using the mini Asthma Quality of Life Questionnaire, the number of asthma attacks, oral corticosteroid cycles, the dose of inhaled corticosteroids, number of emergency visits, unscheduled consultations with the primary care physician and hospitalisations for asthma.ResultsOne hundred and twelve patients were randomised (mean age 55 years, with 87 (78%) being women). Of the 112 patients, 106 (95%) completed the trial. Half the patients (56) were assigned to the intervention group and the other half to the control group. A statistically significant clinical improvement was observed in the intervention group (+3.09) compared with the control group (−0.57) (difference 3.66 (95% CI 0.89 to 5.43); p<0.001) as measured using ACT scores. Among the secondary endpoints, a significant improvement in the quality of life was found in the intervention group (5.34), compared with the control group (4.64) (difference 0.7 (95% CI 0.15 to 1.25); p=0.01).ConclusionAmong adults with asthma and vitamin D deficiency, supplementation with weekly oral calcifediol compared with placebo improved asthma control over 6 months. Further research is needed to assess long-term efficacy and safety.Trial registration numberNCT02805907.

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Relation of Asthma Control with Quality of Life among a Sample of Egyptian Asthmatic School Children

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2019.649 ◽

2019 ◽

Vol 7 (17) ◽

pp. 2780-2785

Author(s):

Hala G. Elnady ◽

Lobna S. Sherif ◽

Rania N. Sabry ◽

Dina Abu Zeid ◽

Hanan Atta ◽

...

Keyword(s):

Quality Of Life ◽

Asthma Control ◽

Asthma Severity ◽

Physical Symptoms ◽

Life Questionnaire ◽

Asthma Control Questionnaire ◽

Asthmatic Children ◽

Asthmatic Patients ◽

Egyptian Children

BACKGROUND: Asthma is considered a chronic health illness that not only resulted in physical symptoms but also emotional effects. It is; therefore, so important to assess the quality of life of asthmatic patients besides their level of disease control. AIM: To determine the correlation of asthma control with the health-related quality of life (HRQOL) of asthmatic children in Egypt. METHODS: One hundred and twenty-eight asthmatic Egyptian children were enrolled in the study. They were subjected to asthma severity grading, asthma control questionnaire (ACQ) and pediatric asthma quality of life questionnaire (PAQLQ). Studied cases were taken from 6 primary and preparatory schools, Giza governorate. RESULTS: The mean child control score was significantly higher in not well-controlled asthmatics compared to well-controlled asthmatics (p < 0.005). The not well controlled asthmatic children showed significantly lower activity limitation score, symptoms score, and overall asthmatic score compared to controlled asthmatic children (p < 0.05). The severity of asthma shows significant positive correlation with symptoms score, emotional function score and overall asthmatic score (p < 0.05). CONCLUSION: The quality of life for the asthmatic children is strongly correlated with the level of asthma control and severity.

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Relationship between Quality of Life and Occupational Accidents in South-East of Iran (Zahedan)

Global Journal of Health Science ◽

10.5539/gjhs.v9n2p112 ◽

2016 ◽

Vol 9 (2) ◽

pp. 112 ◽

Cited By ~ 1

Author(s):

Fereydoon Laal ◽

Mohammad Jafari Modrek ◽

Davoud Balarak ◽

Mahdi Mohammadi ◽

Mahdieh Rakhshani ◽

...

Keyword(s):

Quality Of Life ◽

Psychological Health ◽

Statistical Significance ◽

Occupational Accidents ◽

Control Group ◽

Life Questionnaire ◽

Significant Difference ◽

The Mean ◽

And Control

<p>With the development of science and technology, occupational accidents, as one of the most important problems in the world, result in negative effects on physical and psychological health, and also the quality of life of workers. The aim of this study was to compare the quality of life among workers with and without accident. In a cross-sectional study, 93 workers were selected, 31 who experienced accident and 62 as control group. To gather the data, a researcher-made questionnaire for demographic characteristics and the quality of life questionnaire (SF-36) were used. Mann-Whitney and Chi-square tests were used for data analysis. The mean and standard deviation of age was 30.81±7.29 and 30.56±7.19 in workers with accident (case group) and control group, respectively. Homogeneity was ensured in terms of age and work experience and the two groups had no significant difference in this regard (p>0.05). Most of the participants were high school graduates (67.7%). The majority of accidents (68.8%) had occurred in the manufacturing sections. The most common accident type was sprayed chemical substances (19.4%) and the less frequent was electrocution (3.2%). The mean total score for the quality of life was 37.61±14.29 and 74.92±12.95 in the case and control groups with a statistical significance difference (p<0.001). The results of this study indicate that the incident could affect the quality of life of workers. Therefore, promoting the safety culture can help to reduce the occupational accidents.</p>

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Quality of life questionnaires in children with bronchial asthma at Jordan University Hospital: an observational study

Current Respiratory Medicine Reviews ◽

10.2174/1573398x16999201009155509 ◽

2020 ◽

Vol 16 ◽

Author(s):

Enas M. Al-Zayadneh ◽

Ala’ Dia-Eddin Arafah ◽

Sarah Muwaffag Ibrahim ◽

Maram Abdalla Glessa ◽

Montaha Al-Iede

Keyword(s):

Quality Of Life ◽

Asthma Control ◽

University Hospital ◽

P Value ◽

Life Questionnaire ◽

Asthma Control Test ◽

Cross Sectional ◽

The Mean ◽

Act Score

Background: Asthma is a common chronic illness worldwide. Identifying and treating impaired health-related quality of life is now recognized as an important component of asthma management. High prevalence of behavioral and emotional difficulties was noticed among children with asthma. Methods: Cross-sectional study that was conducted over 8 weeks involving 45 asthmatic children within the ages of 7-17 years old presented to Jordan University Hospital in Amman, Jordan. General demographic characteristics were collected, two questionnaires were used: asthma control test (ACT), and the pediatric asthma quality of life questionnaire (PAQLQ). We also used the feeling thermometer scale, and a pulmonary function test was done for patients. SAS Software version 9.4 USA and Pearsons coefficient were used to find associations. Results and Discussion: Among 45 patients, 53% of the sample had poor asthma control. The mean FEV1 on lung function testing was 80% (± 16.18) of predicted. The mean for asthma clinical scores (ACT) were 18.8 ± 4.53 (out of 25). FEV1 was significantly higher in children with good control compared to those with a low ACT score (P value <0.05). Mean total PAQLQ score was 5.3 ± 1.06 and it correlated significantly with ACT score (P value <0.001). Conclusion: This study highlights the association of poorly controlled asthma with a poor quality of life. It is recommended that the quality of life of children should be assessed and observed during clinic visits, for a better comprehensive approach and effective improvement of outcome.

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Assessment of Asthma Control and Quality of Life among Asthmatic Patients Attending Armed Forces Referral and Teaching Hospital, Addis Ababa, Ethiopia

Pulmonary Medicine ◽

10.1155/2020/5389780 ◽

2020 ◽

Vol 2020 ◽

pp. 1-12

Author(s):

Tesfalidet Gebremeskel Zeru ◽

Ephrem Engidawork ◽

Alemseged Beyene Berha

Keyword(s):

Quality Of Life ◽

Developing Countries ◽

Asthma Control ◽

Teaching Hospital ◽

Armed Forces ◽

Integrated Treatment ◽

Male Gender ◽

Life Questionnaire ◽

Asthmatic Patients

Background. The primary goal of asthma management is to achieve good asthma control. However, poor patient-physician communication, unavailability of appropriate medications, and lack of long-term goals have made asthma control difficult in developing countries. Poor assessment of asthma control and quality of life is a major cause of suboptimal asthma treatment worldwide, and information regarding this issue is scanty in developing countries like Ethiopia. This study thus attempted to assess the level of asthma control and quality of life in asthmatic patients attending Armed Forces Referral and Teaching Hospital. Methods. A cross-sectional study comprising 184 physician-diagnosed asthmatic patients was conducted using interview, chart review, and prescription assessment. Asthma control was assessed using Asthma Control Test, while asthma quality of life was assessed using Mini-Asthma Quality of Life Questionnaire (mini-AQLQ). Spearman’s rank correlation analysis was performed to understand the relationship between mean mini-AQLQ score and asthma control. Receiver operating characteristic curve analysis was performed to establish cut-off values for mini-AQLQ. Results. Asthma was uncontrolled in 67.9% subjects. There was a strong correlation between asthma control and quality of life (rs=0.772; P<0.01). A cut-off value for the quality of life was established at 4.97. Majority of the patients were taking two or three antiasthmatic drugs. Oral tablet and inhaler short-acting beta agonists (SABA) were the frequently combined drugs. Uncontrolled asthma was associated with middle-aged adults (adjusted odds ratio AOR=6.31; 95% CI: 2.06, 19.3; P=0.001), male gender (AOR=0.38; 95% CI: 0.15, 0.98; P=0.044), married (AOR=0.24; 95% CI: 0.08, 0.78; P=0.017), comorbidities (AOR=0.23; 95% CI: 0.09, 0.61; P=0.003), and oral SABA use (AOR=0.22; 95% CI: 0.09, 0.59; P=0.003). Male gender (AOR=0.36; 95% CI: 0.16, 0.84; P=0.018), intermittent asthma (AOR=0.18; 95% CI: 0.04, 0.86; P=0.032), use of oral corticosteroids (AOR=0.22; 95% CI: 0.06, 0.73; P=0.013), and SABA (AOR=0.39; 95% CI: 0.17, 0.89; P=0.026) were found to have a significant association with poor asthma-related quality of life. Conclusion. The findings collectively indicate asthma remains poorly controlled in a large proportion of asthma patients in the study setting. Moreover, quality of life appears to be directly related to asthma control. Healthcare providers should therefore focus on asthma education with an integrated treatment plan to improve asthma control and quality of life.

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Assessment of Quality of Life in Patients with Medication-Related Osteonecrosis of the Jaw Following Reconstructive and Restorative Surgery

Applied Sciences ◽

10.3390/app112411950 ◽

2021 ◽

Vol 11 (24) ◽

pp. 11950

Author(s):

Kirill Arturovich Polyakov ◽

Sofia Vladimirovna Popova ◽

Liudmila Sergeevna Shamanaeva ◽

Sergei Yurievich Ivanov ◽

Pavel Sergeevich Petruk ◽

...

Keyword(s):

Quality Of Life ◽

Radical Surgery ◽

Bodily Pain ◽

Main Group ◽

Control Group ◽

Life Questionnaire ◽

Quality Of Life Questionnaire ◽

Sf 36 ◽

The Mean

Recently, numerous articles have been published describing atypical lesions of the jaw bones related to treatment with medications based on phosphorus or analogs of its compounds, particularly bisphosphonates. Goal: To conduct a comparative analysis of the quality of life after radical surgery of the jaw in patients with medication-related osteonecrosis. A total of 82 patients were interviewed, of which 39 (47.6%) patients were in the control group (conservative treatment) and 43 (52.4%) patients in the main group had radical surgical treatment. The mean age of patients in both groups was 66.8 ± 10.03 years. Treatment of patients in the control group in terms of conventional conservative protocol included the local application of 0.05% chlorhexidine solution 1–2 times a day, antibacterial therapy (clindamycin—150 mg 4 times daily for 7 days) and NSAIDs (nimesulide). Patients in the main group (n = 43) underwent segmental resection of the jaw. Thirty days and then 6 months after the treatment, all patients were asked to assess the intensity of pain using a numerical scale, where 0 = no pain, 5 = moderate pain and 10 = the most severe pain imaginable, and to fill in the SF-36 Quality of Life Questionnaire. Results: An analysis of the results obtained with the Numeric Pain Rating Scale demonstrated that the mean pain intensity before treatment was 8.9 points in the control group, and 9.7 in the main group. These values were indicative of “unbearable pain.” After treatment (30 days), the pain score in the control group decreased and amounted to 4.1, which is evidence of the persistence of “moderate pain” in patients. In patients who underwent segmental jaw resection, the mean pain intensity was 0.5. There was no relationship with gender, but there was a direct relationship between the intensity of the pain and the stage of the process (CI = 95%). The SF-36 quality of life questionnaire showed that in the control group, who were treated conservatively, bodily pain (BoP) decreased from a score of 91.2 to 34.3, and the mental health score increased from 34.2 before treatment to 36.3 after treatment, which indicates the persistence of discomfort. The remaining parameters improved after treatment, but no complete recovery was achieved. Before radical surgery, the main group of patients also had a high level of bodily pain (95.2), but after surgery this decreased to 12.4. The remaining parameters also showed a significant difference before and after radical surgery, indicating a positive trend. Radical surgery allows us to improve the quality of life of patients, thereby confirming that surgical volume is a secondary aspect if there is no relapse after the treatment.

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Defense Mechanisms in Patients with Irritable Bowel Syndrome and Their Relationship with Symptom Severity and Quality of Life

Middle East Journal of Digestive Diseases ◽

10.15171/mejdd.2019.143 ◽

2019 ◽

Vol 11 (3) ◽

pp. 158-165

Author(s):

Fahimeh Saeed ◽

Mansour Salehi ◽

Kaveh Alavi ◽

Hossein Ajdarkosh ◽

Fatemeh Kashaninasab ◽

...

Keyword(s):

Quality Of Life ◽

Irritable Bowel Syndrome ◽

Defense Mechanisms ◽

Control Group ◽

Life Questionnaire ◽

Acting Out ◽

The Mean ◽

Irritable Bowel ◽

Passive Aggression

BACKGROUND Despite the fact that there is theoretical evidence about the association between unconscious defense mechanisms and irritable bowel syndrome (IBS), experimental evidence in this regard is limited. The aim of the present study was to compare the defense mechanisms used by the patients with IBS and a control group, and to investigate the relationship between these mechanisms with the severity of the disease and patients’ quality of life. METHODS Fourty-five patients with IBS (mean age of 37.1 years; 14 males) and 45 controls (mean age of 38.0 years; 13 males) were evaluated. IBS diagnosis was determined based on Rome III criteria and the predominant pattern of the disease was determined based on the patient’s history (13 diarrheapredominant, 16 constipation-predominant, and 16 alternating IBS). Defense Style Questionnaire-40, IBS Severity Scale, and IBS-Quality of Life questionnaire were used. RESULTS The mean scores of projection, acting-out, somatization, autistic fantasy, passive-aggression, and reaction formation in the IBS group were significantly higher than the control group and the mean scores of humor and anticipation mechanisms were higher in the control group. There was no significant correlation between the score of defense mechanisms and the severity of IBS and the patients’ quality of life. CONCLUSION The severity of immature defenses in the IBS group was significantly higher, whereas the severity of mature defenses was higher in the control group. These defenses were not correlated with the severity of IBS. Considering the limited sample size, these relationships need to be more investigated.

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