scholarly journals A 1-day visit in a severe asthma centre: effect on asthma control, quality of life and healthcare use

2016 ◽  
Vol 48 (3) ◽  
pp. 726-733 ◽  
Author(s):  
Akke-Nynke van der Meer ◽  
Henk Pasma ◽  
Wilma Kempenaar-Okkema ◽  
Jo-Anneke Pelinck ◽  
Myrte Schutten ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Asthma Control ◽  
Severe Asthma ◽  
Life Questionnaire ◽  
Healthcare Use ◽  
Uncontrolled Asthma ◽  
Control Quality ◽  
Asthma Patients

Patients with uncontrolled asthma report ongoing symptoms, poor quality-of-life and extensive healthcare use (HCU) and might benefit from management by a specialised severe asthma team. It is unknown whether a one-time evaluation by asthma experts, without long-term supervision by a specialised team, provides favourable outcomes. We evaluated asthma control (Asthma Control Questionnaire; ACQ), quality-of-life (Asthma-related Quality of Life Questionnaire; AQLQ) and HCU before and 1 year after a 1-day visit programme in a severe asthma centre, including a multidisciplinary assessment resulting in a personalised management plan to be implemented by patients own pulmonologists.40 uncontrolled asthma patients completed questionnaires (ACQ, AQLQ, HCU) at baseline, and 6 and 12 months follow-up.ACQ improved from 2.6 (interquartile range 1.7–3.2) to 1.8 (1.2–3.2) (p=0.003) and AQLQ from 4.8 (4.0–5.2) to 5.3 (4.4–6.0) (p<0.001). We found a reduction in patients with ≥2 exacerbations (95% versus 17%; p<0.001), ≥1 emergency room visit (78% versus 37%; p<0.001) and ≥1 hospitalisation (47% versus 10%; p=0.001).Evaluation of uncontrolled asthma patients in a 1-day visit programme in a severe asthma centre resulted in significant improvements in asthma control, quality-of-life and healthcare use after 1 year. This 1-day visit approach seems beneficial for uncontrolled asthma patients and might reduce their dependence on expensive treatment modalities and long-term management in specialised centres.

scholarly journals Is ventilation heterogeneity related to asthma control?

2016 ◽  
Vol 48 (2) ◽  
pp. 370-379 ◽  
Author(s):  
Sarah Svenningsen ◽  
Parameswaran Nair ◽  
Fumin Guo ◽  
David G. McCormack ◽  
Grace Parraga
Keyword(s):  
Quality Of Life ◽  
Asthma Control ◽  
Forced Expiratory Volume ◽  
Life Questionnaire ◽  
Strongly Correlated ◽  
Asthma Control Questionnaire ◽  
Asthma Patients ◽  
Ventilation Heterogeneity ◽  
Magnetic Resonance Imaging Mri

In asthma patients, magnetic resonance imaging (MRI) and the lung clearance index (LCI) have revealed persistent ventilation heterogeneity, although its relationship to asthma control is not well understood. Therefore, our goal was to explore the relationship of MRI ventilation defects and the LCI with asthma control and quality of life in patients with severe, poorly controlled asthma.18 patients with severe, poorly controlled asthma (mean±sd 46±12 years, six males/12 females) provided written informed consent to an ethics board approved protocol, and underwent spirometry, LCI and 3He MRI during a single 2-h visit. Asthma control and quality of life were evaluated using the Asthma Control Questionnaire (ACQ) and Asthma Quality of Life Questionnaire (AQLQ). Ventilation heterogeneity was quantified using the LCI and 3He MRI ventilation defect percent (VDP).All participants reported poorly controlled disease (mean±sd ACQ score=2.3±0.9) and highly heterogeneous ventilation (mean±sd VDP=12±11% and LCI=10.5±3.0). While VDP and LCI were strongly correlated (r=0.86, p<0.0001), in a multivariate model that included forced expiratory volume in 1 s, VDP and LCI, VDP was the only independent predictor of asthma control (R2=0.38, p=0.01). There was also a significantly worse VDP, but not LCI in asthma patients with an ACQ score >2 (p=0.04) and AQLQ score <5 (p=0.04), and a trend towards worse VDP (p=0.053), but not LCI in asthma patients reporting ≥1 exacerbation in the past 6 months.In patients with poorly controlled, severe asthma MRI ventilation, but not LCI was significantly worse in those with worse ACQ and AQLQ.

scholarly journals Effects of an outpatient education program in patients with uncontrolled asthma

2013 ◽  
Vol 39 (3) ◽  
pp. 272-279 ◽  
Author(s):  
Carmen Denise Borba Rodrigues ◽  
Rosemary Petrik Pereira ◽  
Paulo de Tarso Roth Dalcin
Keyword(s):  
Quality Of Life ◽  
Asthma Control ◽  
Educational Intervention ◽  
Education Program ◽  
Inhalation Technique ◽  
Uncontrolled Asthma ◽  
Face To Face ◽  
Metered Dose ◽  
Asthma Patients

OBJECTIVE: To evaluate the effects of an outpatient education program in patients with uncontrolled asthma. METHODS: This was an uncontrolled study evaluating an educational intervention and involving patients with uncontrolled asthma ≥ 14 years of age. The participants completed a questionnaire designed to assess the level of asthma control, the inhalation technique, and quality of life. All of the patients underwent pulmonary function testing, after which they participated in an education program consisting of one 45-min face-to-face session, followed by phone interviews at two, four, and eight weeks. The participants were reevaluated after three months. RESULTS: Sixty-three patients completed the study. There was a significant improvement in the level of asthma control (p < 0.001). Of the 63 patients, 28 (44.4%) and 6 (9.5%) were classified as having partially controlled asthma and controlled asthma, respectively. The mean FEV1 was 63.0 ± 20.0% and 68.5 ± 21.2% of the predicted value prior to and after the educational intervention, respectively (p = 0.002), and all of the quality of life scores improved (p < 0.05 for all). The same was true for the proportion of patients prior to and after the educational intervention using the proper inhalation technique when using metered dose inhalers (15.4% vs. 46.2%; p = 0.02) and dry powder inhalers (21.3% vs. 76.6%; p < 0.001). The logistic regression analysis revealed that an incorrect inhalation technique identified during the first evaluation was independently associated with a favorable response to the educational intervention. CONCLUSIONS: This study suggests that an outpatient education program for asthma patients improves the level of asthma control, lung function parameters, and quality of life. An incorrect inhalation technique identified during the first evaluation was predictive of a favorable response to the educational intervention.

scholarly journals COVID-19 Vaccination in Patients with Severe Asthma on Biologic Treatment: Safety, Tolerability, and Impact on Disease Control

Vaccines ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 853
Author(s):  
Marco Caminati ◽  
Gabriella Guarnieri ◽  
Veronica Batani ◽  
Elena Scarpieri ◽  
Anita Finocchiaro ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Disease Control ◽  
Severe Asthma ◽  
Vaccination Campaign ◽  
Tolerability Profile ◽  
Life Questionnaire ◽  
Biologic Treatment ◽  
Asthma Patients

Background: COVID-19 vaccination has been recommended for severe asthmatics. We aimed to evaluate the safety, tolerability, and impact on disease control and patient’s quality of life of the mRNA SARS-CoV-2/COVID-19 vaccine in severe asthma patients regarding biologic treatment. Methods: Severe asthmatic patients regularly managed by two big allergy and respiratory referral centers were offered to undergo Pfizer COVID 19 vaccination at the hospital site. Patients filled in an adverse events questionnaire after the first and second dose, as well as the Asthma Control Test (ACT) and Asthma Quality of Life Questionnaire (AQLQ). Results: Overall, 253 patients were vaccinated; only 16 patients refused. No serious events were detected. Less than 20% of patients reported side effects, most of which were classified as very common side effects. No differences were reported according to the ongoing biologic drug. A significant improvement in both ACT and AQLQ was observed between the first and the second dose administration. Conclusions: Our data confirm the optimal safety and tolerability profile of mRNA SARS- CoV-2/COVID-19 in severe asthma patients on biologic treatment, as well as their positive attitude towards COVID-19 vaccination. The negligible proportion of patients reporting side effects and the absence of asthma exacerbations are relevant to support the COVID-19 vaccination campaign in severe asthma patients worldwide.

scholarly journals The Relation between Asthma Control and Quality of Life in Children

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
M. Banjari ◽  
Y. Kano ◽  
S. Almadani ◽  
A. Basakran ◽  
M. Al-Hindi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Asthma Control ◽  
Holistic Approach ◽  
Well Being ◽  
Life Questionnaire ◽  
Uncontrolled Asthma ◽  
Asthma Control Test ◽  
Cross Sectional ◽  
Asthmatic Children

Background. Asthma is a common chronic illness worldwide. Asthmatic children are forced to alter their way of living to avoid its complications or exacerbations, which negatively affects their psychological and social well-being. High prevalence of behavioral and emotional difficulties was noticed among children with asthma. Methods. Cross-sectional study that was conducted over 8 months involving asthmatic children within the ages of 7-17 years presenting to two governmental hospitals in Jeddah, Saudi Arabia. Three questionnaires were used: asthma control test, the strengths and difficulties questionnaire, and the pediatrics asthma quality of life questionnaire. Using SPSS, Pearson’s chi-square and independent sample t-tests were used to find associations. Results. Among the 106 respondents, 84% of the sample had poor asthma control. Significantly poorer quality of life was observed in children with uncontrolled asthma (p = <0.001). Children with controlled and uncontrolled asthma were equally affected psychosocially with no relation between asthma control and their psychosocial well-being (p = 0.58). Conclusion. The majority of asthmatic children were uncontrolled with poor quality of life. This study recommends that the psychosocial well-being should be assessed during clinic visits for a better holistic approach and effective improvement of outcome. Further researches are needed to study the psychological effect of asthma.

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

2018 ◽  
Vol 7 (12) ◽  
pp. 471 ◽  
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.

scholarly journals Assessment of quality of life in asthma patients in 5 to 18 years of children

2020 ◽  
Vol 7 (11) ◽  
pp. 2214
Author(s):  
Nikhil Jain ◽  
Karan Joshi
Keyword(s):  
Quality Of Life ◽  
Asthma Control ◽  
Persistent Asthma ◽  
Tertiary Hospital ◽  
P Value ◽  
Cross Sectional ◽  
Asthmatic Patients ◽  
Asthma Patients ◽  
Severity Of The Disease

Background: Asthma is a common cause of morbidity and mortality with prevalence of 300 million in world. The QOL of asthmatic patients cannot be determined only on the basis the severity of the disease, but requires a measurement of personal perception. This study was conducted with the aim to assess and compare the QOL using PedsQl scale in asthma patients between 5 to 18 years of age with different demographic and clinical variables.Methods: This was a cross-sectional observational study conducted at respiratory clinic in tertiary hospital, Rewa from October 2017 to June 2019. A total number of 150 asthmatic patients and their parents participated. Asthmatic patients (N=150) and their parents, presenting to asthma clinic of Gandhi Memorial Hospital, Rewa (after applying inclusion-exclusion criteria) were assessed for QOL using PedsQl scale 3.0. Statistical analysis was performed by SPSS version 20. Test of significance by student T-test and one way ANOVA.Results: The QOL is severely hampered by asthma with mean of 59 in intermittent asthma, 51 in mild, 44.74 in moderate and 40 in severe persistent asthma, significant p value of <0.05. Younger age, level of asthma control and severity were significantly related to QOL with p value of <0.05. Sex, socioeconomic status, were insignificantly related.Conclusions: QOL is impaired as the grading of asthma increases. Impairment of Quality of life are mostly associated with low level of asthma control, poly-therapy and frequent night attacks.

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