“App” for uncontrolled moderate-severe asthma patients follow-up

2017 ◽  
Author(s):  
Sonia Herrero Martin ◽  
Javier Hueto Perez de Heredia ◽  
Marisol Gomez ◽  
Alberto Cuesta Remon ◽  
Francisco Campano Lancharro ◽  
...  
Keyword(s):  
Severe Asthma ◽  
Asthma Patients

scholarly journals Trends in oral corticosteroids use in severe asthma: a 14-year population-based study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Mohsen Sadatsafavi ◽  
Amir Khakban ◽  
Hamid Tavakoli ◽  
Solmaz Ehteshami-Afshar ◽  
Larry D. Lynd ◽  
...  
Keyword(s):  
Severe Asthma ◽  
Poisson Regression ◽  
Population Based ◽  
Population Based Study ◽  
Factors Associated ◽  
Asthma Patients ◽  
Oral Corticosteroids ◽  
Administrative Health Databases ◽  
Time Since Diagnosis

Abstract Background Oral corticosteroids are important components of pharmacotherapy in severe asthma. Our objective was to describe the extent, trends, and factors associated with exposure to oral corticosteroids (OCS) in a severe asthma cohort. Methods We used administrative health databases of British Columbia, Canada (2000–2014) and validated algorithms to retrospectively create a cohort of severe asthma patients. Exposure to OCS within each year of follow-up was measured in two ways: maintenance use as receiving on average ≥ 2.5 mg/day (prednisone-equivalent) OCS, and episodic use as the number of distinct episodes of OCS exposure for up to 14 days. Trends and factors associated with exposure on three time axes (calendar year, age, and time since diagnosis) were evaluated using Poisson regression. Results 21,144 patients (55.4% female; mean entry age 28.7) contributed 40,803 follow-up years, in 8.2% of which OCS was used as maintenance therapy. Maintenance OCS use declined by 3.8%/calendar year (p < 0.001). The average number of episodes of OCS use was 0.89/year, which increased by 1.1%/calendar year (p < 0.001). Trends remained significant for both exposure types in adjusted analyses. Both maintenance and episodic use increased by age and time since diagnosis. Conclusions This population-based study documented a secular downward trend in maintenance OCS use in a period before widespread use of biologics. This might have been responsible for a higher rate of exacerbations that required episodic OCS therapy. Such trends in OCS use might be due to changes in the epidemiology of severe asthma, or changes in patient and provider preferences over time.

Comparison of exacerbation phenotypes among patients with severe asthma

2020 ◽  
Vol 41 (4) ◽  
pp. e67-e79
Author(s):  
Karina Ruth Soenjoyo ◽  
Nivedita Nadkarni ◽  
Mariko Siyue Koh
Keyword(s):  
Severe Asthma ◽  
Immunoglobulin E ◽  
Laboratory Data ◽  
Therapeutic Strategies ◽  
Demographic Differences ◽  
Asthma Exacerbations ◽  
Singapore General Hospital ◽  
Asthma Patients ◽  
Hospital Stays

Background: Exacerbation phenotypes among patients with severe asthma have been largely characterized during stable periods. Little is known about severe asthma patients during exacerbation periods. Objective: To compare persistently frequent exacerbators (PFE), non‐persistently frequent exacerbators (NPFE), and infrequent exacerbators (IFE) among patients with severe asthma during stable and exacerbation periods. Methods: Patients with severe asthma who were admitted for asthma exacerbations from 2011 to 2017 and on follow up at Singapore General Hospital were recruited and categorized as PFEs (two or more exacerbations per year over 2 consecutive years), NPFEs (two or more exacerbations in 1 year only), or IFEs (fewer than two exacerbations per year over 2 consecutive years). Demographic, clinical, and laboratory data were collected at baseline and during exacerbation periods. Results: The participants were categorized as the following: 20 PFEs, 36 NPFEs, and 57 IFEs, with no significant demographic differences. The participants as PFEs (versus NPFEs and IFEs) were characterized by having a higher prevalence of psychiatric disorders (25% versus 8% versus 5%; p = 0.046), more comorbidities (7 versus 4 versus 2; p < 0.001), and a higher steroid burden per year (1150 versus 456 versus 350 mg; p < 0.001). The participants who were PFEs (versus IFEs) had a higher total immunoglobulin E (IgE) level (625 versus 232 IU/mL; p = 0.046) and longer duration of admission stay (3 versus 2 days; p = 0.009). All three groups had higher blood neutrophil counts during exacerbation periods than during stable periods (p = 0.008 versus p < 0.001 versus p = 0.004). Conclusion: The participants categorized as PFEs were characterized by comorbidities, higher steroid burden, IgE levels, and longer hospital stays. Exacerbations in the participants with severe asthma, regardless of exacerbation phenotype, were characterized by neutrophilia. These findings provided insights into potential therapeutic strategies to reduce exacerbations in patients with severe asthma.

scholarly journals Newly Diagnosed Asthma in China: Initial Severity and Changes Over 1-year Management

2021 ◽  
Author(s):  
Zhizhen Hu ◽  
Jianwei Xuan ◽  
Haijin Zhao ◽  
Hangming Dong ◽  
Changhui Yu ◽  
...  
Keyword(s):  
Severe Asthma ◽  
Asthma Severity ◽  
Initial Diagnosis ◽  
Mild Asthma ◽  
First Year ◽  
Newly Diagnosed ◽  
Medical Database ◽  
Asthma Patients ◽  
First Diagnosis

Abstract Background: The prevalence of adult asthma is increasing in China. However, there are no large sample, epidemiological data describing asthma severity at the time of new diagnosis and changes during follow-up management. Thus, the purpose of this study was to use a large health care database to examine asthma severity at initial diagnosis, and changes in severity over the first year of management.Methods: Data of patients with a first diagnosis of asthma were extracted from the SuValue electronic medical database. Inclusion criteria were: 1) At least 14 years old at the time of first diagnosis; 2) Initial diagnosis from 2001 to March 2019; 3) Followed-up for at least 12 months; 4) Had a follow-up visit every 3 months. Disease severity at diagnosis and at each follow-up visit, medications prescribed, and symptoms were collected and analysed.Results: A total of 7,654 adult patients with newly diagnosed asthma from tertiary hospitals (26.38%) and secondary hospitals (73.62%) who were followed-up for at least 12 months were included. Approximately 54% were females, and the proportion of patients over 60 years old was the highest (38%). Of all patients, 53.91% were not prescribed medications to control asthma, suggesting that these patients were mild asthma. Approximately 16% of patients were prescribed oral corticosteroid and/or inhaled corticosteroid and long-acting β2-agonist combination, suggesting moderate to severe asthma. The proportions of patients with moderate and severe decreased during the first 6 months, and then the proportions remained stable. The proportion of patients with severe asthma remained stable from the 6th month onward. At the end of the year 2.7% of patients had severe asthma. Patients with mild asthma tended to continue to have mild asthma in the following 3 months (> 76.19%). However, of the patients with mild and moderate asthma at 3 months, 92.85% and 75.1%, respectively, had a reduction in severity and had mild asthma at 12 months. On the other hand, 1.26% and 3.15%, respectively, progressed to severe asthma by 12 months.Conclusion: During the first year after an initial diagnosis of asthma patients diagnosed with mild asthma tended to not progress and remained stable with mild asthma over the year. The proportions of patients diagnosed with moderate and severe asthma remained stable over the year. Further study is needed to examine the clinical features of newly diagnosed patients with severe asthma who do not experience a reduction in severity in order to target these patients for more intensive treatment and reduce the disease burden.

scholarly journals Trends in oral corticosteroids use in severe asthma: a 14-year population-based study from Canada

2020 ◽  
Author(s):  
Mohsen Sadatsafavi ◽  
Amir Khakban ◽  
Hamid Tavakoli ◽  
Solmaz Ehteshami-Afshar ◽  
Larry D. Lynd ◽  
...  
Keyword(s):  
Severe Asthma ◽  
Poisson Regression ◽  
Population Based ◽  
Population Based Study ◽  
Factors Associated ◽  
Asthma Patients ◽  
Oral Corticosteroids ◽  
Administrative Health Databases ◽  
Time Since Diagnosis

Abstract Background: Oral corticosteroids are important components of pharmacotherapy in severe asthma. Our objective was to describe the extent, trends, and factors associated with exposure to oral corticosteroids (OCS) in a severe asthma cohort.Methods: We used administrative health databases of British Columbia, Canada (2000–2014) and validated algorithms to retrospectively create a cohort of severe asthma patients. Exposure to OCS within each year of follow-up was measured in two ways: maintenance use as receiving on average ≥2.5 mg/day (prednisone-equivalent) OCS, and episodic use as the number of distinct episodes of OCS exposure for up to 14 days. Trends and factors associated with exposure on three time axes (calendar year, age, and time since diagnosis) were evaluated using Poisson regression.Results: 21,144 patients (55.4% female; mean entry age 28.7) contributed 40,803 follow-up years, in 8.2% of which OCS was used as maintenance therapy. Maintenance OCS use declined by 3.8%/calendar year (p<0.001). The average number of episodes of OCS use was 0.89/year, which increased by 1.1%/calendar year (p<0.001). Trends remained significant for both exposure types in adjusted analyses. Both maintenance and episodic use increased by age and time since diagnosis. Conclusions: This population-based study documented a secular downward trend in maintenance OCS use in a period before widespread use of biologics. This might have been responsible for a higher rate of exacerbations that required episodic OCS therapy. Such trends in OCS use might be due to changes in the epidemiology of severe asthma, or changes in patient and provider preferences over time.

scholarly journals Trends in oral corticosteroids use in severe asthma: a 14-year population-based study from Canada

2020 ◽  
Author(s):  
Mohsen Sadatsafavi ◽  
Amir Khakban ◽  
Hamid Tavakoli ◽  
Solmaz Ehteshami-Afshar ◽  
Larry Lynd ◽  
...  
Keyword(s):  
Severe Asthma ◽  
Poisson Regression ◽  
Population Based ◽  
Population Based Study ◽  
Factors Associated ◽  
Asthma Patients ◽  
Oral Corticosteroids ◽  
Administrative Health Databases ◽  
Time Since Diagnosis

Abstract Background: Oral corticosteroids are important components of pharmacotherapy in severe asthma. Our objective was to describe the extent, trends, and factors associated with exposure to oral corticosteroids (OCS) in a severe asthma cohort.Methods: We used administrative health databases of British Columbia, Canada (2000–2014) and validated algorithms to retrospectively create a cohort of severe asthma patients. Exposure to OCS within each year of follow-up was measured in two ways: maintenance use as receiving on average ≥2.5 mg/day (prednisone-equivalent) OCS, and episodic use as the number of distinct episodes of OCS exposure for up to 14 days. Trends and factors associated with exposure on three time axes (calendar year, age, and time since diagnosis) were evaluated using Poisson regression.Results: 21,144 patients (55.4% female; mean entry age 28.7) contributed 40,803 follow-up years, in 8.2% of which OCS was used as maintenance therapy. Maintenance OCS use declined by 3.8%/calendar year (p<0.001). The average number of episodes of OCS use was 0.89/year, which increased by 1.1%/calendar year (p<0.001). Trends remained significant for both exposure types in adjusted analyses. Both maintenance and episodic use increased by age and time since diagnosis.Conclusions: This population-based study documented a secular downward trend in maintenance OCS use in a period before widespread use of biologics. This might have been responsible for a higher rate of exacerbations that required episodic OCS therapy. Such trends in OCS use might be due to changes in the epidemiology of severe asthma, or changes in patient and provider preferences over time.

A longitudinal follow-up of severe asthma patients receiving reslizumab

2017 ◽  
Author(s):  
Pascal Chanez ◽  
Margaret Garin ◽  
Mirna McDonald ◽  
Laurie Pahus ◽  
Arnaud Bourdin
Keyword(s):  
Severe Asthma ◽  
Asthma Patients

Strict Adherence To A Follow-Up Improves Disease Control In Severe Asthma Patients

2011 ◽  
Author(s):  
Pierluigi Paggiaro ◽  
Federico L. Dente ◽  
Giulia Spoletini ◽  
Lorenza Melosini ◽  
Federica Novelli ◽  
...  
Keyword(s):  
Disease Control ◽  
Severe Asthma ◽  
Strict Adherence ◽  
Asthma Patients

scholarly journals Severe Asthma, Telemedicine, Self-Administered Therapy: Listening First to the Patient

2021 ◽  
Author(s):  
Gabriella Guarnieri ◽  
Marco Caminati ◽  
Alessia Achille ◽  
Rachele Vaia ◽  
Fulvia Chieco Bianchi ◽  
...  
Keyword(s):  
Severe Asthma ◽  
Ad Hoc ◽  
Standard Of Care ◽  
Healthcare Personnel ◽  
Self Administration ◽  
Asthmatic Patients ◽  
Increased Risk ◽  
Asthma Patients ◽  
E Mail

Severe asthma patients are at increased risk of major exacerbations and they need to be monitored regularly. The COVID-19 pandemic has impressively impacted on the health care resources. The telemedicine approach applied to the follow-up of asthmatic patients has been proved to be effective in monitoring their disease and adherence to the therapy. The aim of our study was to investigate the satisfaction of severe asthma patients, before the activation of a telemedicine management complemented by a standard of care. An ad hoc questionnaire was developed and sent by e-mail to 180 severe asthma patients. Most of subjects (82%) were confident with the idea of doing self-measurements and self-managing their disease; 77% of subjects favoured to carry out virtual visit and telemedicine. 93% of patients considered easy the self-injection therapy. 94% of subjects felt safe and 93% were not worried while self-administering. Only mild adverse events were reported in 22% subjects after self-administration. Our results showed an agreement between what is considered necessary and practicable by healthcare personnel and what is perceived by the severe asthma patients, in terms of treatment and monitoring of the disease with Telehealth. Biologics have a safety profile and can be easily self-administred at home

scholarly journals Severe Asthma Patients Experience and Satisfaction with Virtual Clinics during COVID-19 Period

2021 ◽  
Author(s):  
Mohammad Ayaz Khan ◽  
Rajendram Rajkumar ◽  
Mohammad Hammadi ◽  
Majed Al-Gamedi ◽  
Abdullah Al-Harbi ◽  
...  
Keyword(s):  
Severe Asthma ◽  
Biologic Therapy ◽  
Demographic Data ◽  
Tertiary Care ◽  
Biologic Agent ◽  
Subjective Perception ◽  
Cross Sectional Survey ◽  
Asthma Patients ◽  
The Impact

Background Enforced social distancing (i.e., lockdowns) greatly facilitated control of coronavirus disease-19 (COVID-19). While access to hospitals was restricted, outpatient care continued remotely. The aim of this study was to determine the satisfaction of patients with severe asthma with telemedicine, and the impact of COVID-19 lockdown on severe asthma patients on biologics therapy. Methods A cross-sectional survey of patients with severe asthma scheduled to receive biologic therapy at our hospital during the lockdown. The survey had sections about demographic data, asthma history, subjective perception of change in asthma control with biologic agent, the effect of COVID-19 pandemic on access to maintenance therapy for asthma, asthma exacerbation management, and satisfaction with telephone follow-up. Results Fifty-four patients participated (response rate 93.1%; male 17; mean age 46.7 years). All had been on biologic therapy for over 3 months (mean 38.4 months ± standard deviation 26.5 months). Of the 45 patients living in Riyadh, 9 did not receive biologic therapy. Five of the nine patients living outside Riyadh did not receive biologic therapy. Alarmingly, 16 (29.6%) had insufficient medications, and 27 (50%) had difficulty obtaining medications. Fifty (92.6%) had telephone follow-up, 31 (57.4%) were satisfied with telemedicine. Conclusion Many patients were satisfied with telemedicine, so this could be used to deliver routine outpatient tertiary care postpandemic. However, logistics around supplying medications and biologics must be considered in plans preparing for the second wave of COVID-19.

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