scholarly journals Follow-up of patients with uncontrolled asthma: clinical features of asthma patients according to the level of control achieved (the COAS study)

2017 ◽  
Vol 49 (3) ◽  
pp. 1501885 ◽  
Author(s):  
Rosa Munoz-Cano ◽  
Alfons Torrego ◽  
Joan Bartra ◽  
Jaime Sanchez-Lopez ◽  
Rosa Palomino ◽  
...  
Keyword(s):  
Lung Function ◽  
Asthma Control ◽  
Forced Expiratory Volume ◽  
Uncontrolled Asthma ◽  
Asthma Control Test ◽  
Disease Evolution ◽  
Factors Associated ◽  
Asthma Patients ◽  
The Mean ◽  
Global Initiative

Our aim was to study the asthma control achieved in patients with uncontrolled asthma who had received appropriate treatment according to the Global Initiative for Asthma (GINA) 2010 (valid at the time the study was designed), and to analyse the factors associated with a lack of asthma control.This was a multicentre study in routine clinical practice performed in patients with uncontrolled asthma according to GINA 2010. At visit 1, we recorded demographics, asthma characteristics and spirometry. We assessed asthma control using GINA 2010 criteria and the Asthma Control Test (ACT). Treatment was optimised according to GINA 2010. At visit 2, 3 months later, we reassessed spirometry, asthma control and factors associated with failure to achieve control.We recruited 1299 patients with uncontrolled asthma (mean age 46.5±17.3 years, 60.7% women, 25.8% obese). The mean percentage of predicted forced expiratory volume in 1 s was 76.4±12.8% and the mean post-bronchodilator increase was 14.9±6.8%. We observed poor agreement between ACT and GINA 2010 when evaluating asthma control (kappa = −0.151). At visit 2, asthma in 71.2% of patients was still not fully controlled. Patients whose asthma remained uncontrolled were older, had a higher body mass index, greater disease severity, longer disease evolution and worse lung function.After treatment optimisation, most patients did not achieve optimal control according to GINA 2010. Risk factors for failure to achieve asthma control were time of disease evolution, severity, age, weight and lung function impairment (excluded in the GINA 2014).

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 Meta-analysis of vitamin D and lung function in patients with asthma

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Jian Liu ◽  
Yong-Quan Dong ◽  
Jie Yin ◽  
Jian Yao ◽  
Jie Shen ◽  
...  
Keyword(s):  
Vitamin D ◽  
Lung Function ◽  
Meta Analysis ◽  
Serum Vitamin ◽  
Forced Expiratory Volume ◽  
Asthma Control Test ◽  
Serum Vitamin D ◽  
Vitamin D Levels ◽  
Asthma Patients ◽  
Sufficient Vitamin

Abstract Background There is growing literature suggesting a link between vitamin D and asthma lung function, but the results from systematic reviews are conflicting. We conducted this meta-analysis to investigate the relation between serum vitamin D and lung function in asthma patients. Methods Major databases, including OVID, MEDLINE, Web of Science and PUBMED, were searched until 10th October 2018. All published observational studies related to vitamin D and asthma were extracted. All meta-analyses were performed using Review Manager 5.3.5. Results This quantitative synthesis found that asthma patients with low vitamin D levels had lower forced expiratory volume In 1 s (FEV1) (mean difference (MD) = − 0.1, 95% CI = − 0.11 to − 0.08,p < 0.01;I2 = 49%, p = 0.12) and FEV1% (MD = − 10.02, 95% CI = − 11 to − 9.04, p < 0.01; I2 = 0%, p = 0.82) than those with sufficient vitamin D levels. A positive relation was found between vitamin D and FEV1 (r = 0.12, 95% CI = 0.04 to 0.2, p = 0.003; I2 = 59%,p = 0.01), FEV1% (r = 0.19, 95% CI = 0.13 to 0.26, p < 0.001; I2 = 42%, p = 0.11), forced vital capacity (FVC) (r = 0.17, 95% CI = 0.00 to 0.34, p = 0.05; I2 = 60%, p = 0.04), FEV1/FVC (r = 0.4, 95% CI = 0.3 to 0.51, p < 0.001; I2 = 48%, p = 0.07), and the asthma control test (ACT) (r = 0.33, 95% CI = 0.2 to 0.47, p < 0.001; I2 = 0%, p = 0.7). Subgroup analysis indicated that the positive correlation between vitamin D and lung function remained significant in both children and adults. Conclusions Our meta-analysis suggested that serum vitamin D levels may be positively correlated with lung function in asthma patients. Future comprehensive studies are required to confirm these relations and to elucidate potential mechanisms.

scholarly journals Level of asthma control and its relationship with medication use in asthma patients in Brazil

2014 ◽  
Vol 40 (5) ◽  
pp. 487-494 ◽  
Author(s):  
Josiane Marchioro ◽  
Mariana Rodrigues Gazzotti ◽  
Oliver Augusto Nascimento ◽  
Federico Montealegre ◽  
James Fish ◽  
...  
Keyword(s):  
Asthma Control ◽  
Latin American ◽  
Rescue Medication ◽  
Uncontrolled Asthma ◽  
The Past ◽  
Global Initiative For Asthma ◽  
Asthma Patients ◽  
Oral Corticosteroids ◽  
Global Initiative ◽  
Asthma Group

OBJECTIVE: To assess asthma patients in Brazil in terms of the level of asthma control, compliance with maintenance treatment, and the use of rescue medication. METHODS: We used data from a Latin American survey of a total of 400 asthma patients in four Brazilian state capitals, all of whom completed a questionnaire regarding asthma control and treatment. RESULTS: In that sample, the prevalence of asthma was 8.8%. Among the 400 patients studied, asthma was classified, in accordance with the Global Initiative for Asthma criteria, as controlled, partially controlled, and uncontrolled in 37 (9.3%), 226 (56.5%), and 137 (34.3%), respectively. In those three groups, the proportion of patients on maintenance therapy in the past four weeks was 5.4%, 19.9%, and 41.6%, respectively. The use of rescue medication was significantly more common in the uncontrolled asthma group (86.9%; p < 0.001). CONCLUSIONS: Our findings suggest that, in accordance with the established international criteria, asthma is uncontrolled in the vast majority of asthma patients in Brazil. Maintenance medications are still underutilized in Brazil, and patients with partially controlled or uncontrolled asthma are more likely to use rescue medications and oral corticosteroids.

scholarly journals Disease control in patients with asthma and respiratory symptoms (wheezing, cough) during sleep

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Jonathan Doenges ◽  
Elisabeth Kuckuck ◽  
Werner Cassel ◽  
Olaf Hildebrandt ◽  
Andreas Weissflog ◽  
...  
Keyword(s):  
Asthma Control ◽  
Respiratory Symptoms ◽  
Asthma Management ◽  
Objective Evaluation ◽  
Uncontrolled Asthma ◽  
Asthma Control Test ◽  
Asthmatic Patients ◽  
Significant Difference ◽  
Asthma Patients ◽  
Act Score

Abstract Introduction The Global Initiative for Asthma (GINA)-defined criteria for asthma control include questions about daytime symptoms, limitation of activity, nocturnal symptoms, need for reliever treatment and patients’ satisfaction. Patients with nocturnal symptoms like wheezing and cough often suffer from lower sleep quality and impaired daytime performance. The lack of an appropriate method for standardized and objective monitoring of respiratory symptoms leads to difficulties in asthma management. The aim of this study is to present a new method for automated wheeze and cough detection during sleep and to assess the actual level of asthma control by the Asthma Control Test (ACT). Methods Respiratory symptoms like wheezing and cough were recorded with the LEOSound-Monitor for one night in 55 asthmatic patients in their individual domestic setting. Patients were asked to assess their level of asthma subjectively with the ACT. The study consisted of 37 women and 18 men, with a mean age of 41 years, and a mean BMI of 27 kg/m2. Most of the patients had been taking an ICS/LABA combination and would resort to a SABA as their rescue medication. Results 60% of the participants were classed as having controlled, and 40% were classed as having partially- or uncontrolled asthma. During sleep wheezing was found in 8 of the 55 asthma patients (14.5%) and coughing was found in 30 patients (54.5%). The median ACT score in wheezing-patients was 14, while in non-wheezing patients it was 21. Uncontrolled asthma was found in 6 of the 8 wheezing-patients. Coughing versus non-coughing patients did not show a significant difference in the ACT-score (20, 22 respectively). Conclusion Wheezing is a sign of uncontrolled asthma. The ACT-score in wheezing patients is worse compared to patients without wheezing. LEOSound proofed to be a useful tool in providing an objective evaluation of respiratory symptoms, like coughing and wheezing. In clinical practice, this may allow an improvement in asthma therapy.

scholarly journals The Role of FENO in Comparison to Spirometry and ACT in Control of Children Asthma Symptoms

2019 ◽  
Author(s):  
Abbas Dabbaghzadeh ◽  
Marzieh Tavakol ◽  
Mohammad Gharagozlou
Keyword(s):  
Asthma Control ◽  
Medical Center ◽  
Lung Function Test ◽  
Cross Sectional Study ◽  
Forced Expiratory Volume ◽  
Asthma Control Test ◽  
Cross Sectional ◽  
Before And After ◽  
The Mean ◽  
Act Score

  Fractional exhaled nitric oxide (FeNO) is a noninvasive marker of inflammation, used for monitoring asthma. The aim of this study was to compare FeNO, asthma control test (ACT), and lung function test (spirometry) in children aged 8-15 years. This observational, cross-sectional study was performed on76 asthmatic children (age, 8-15 years), who were referred to the Department of Immunology and Allergy, Children's Medical Center, Tehran, Iran during 2012-2013. Patients were matched for sex and age. The recruited patients were selected via consecutive sampling. FeNO was measured with a portable electrochemical analyzer and forced spirometry was performed according to the American Thoracic Society (ATS) guidelines. The ACT questionnaire was used and completed for all the patients.  The mean FeNO was 28.5±29.1 ppb, and the mean ACT score was 19.8±3.6. FeNO was significantly correlated with forced expiratory volume (FEV1) (r, 0.232; p=0.049) or 25-75% maximum expiratory flow (MEF 25-75) (r, -0.304; p=0.009). FeNO showed no significant correlation with ACT score or FEV1/forced vital capacity (FVC) (p>0.05). Additionally, there was no significant correlation between FeNO and changes in FEV1 and MEF 25-75% before and after the administration of bronchodilators (p>0.05). To improve asthma control, childhood ACT, FeNO, and spirometric tests can be used as complementary tools in clinical practice to detect children with poorly controlled asthma.

scholarly journals Is there an association between the value of forced expiratory volume in the 1st second, the Asthma Control Test and a Control Framework by Global Initiative for asthma in asthmatic children and adolescents treated with inhaled corticosteroids?

2019 ◽  
Vol 29 (3) ◽  
pp. 346-353
Author(s):  
Karla Delevedove Taglia-Ferre ◽  
Sandra Lisboa ◽  
Luanda Dias da S. Salviano ◽  
Ana Carolina Carioca da Costa ◽  
Shandra Lisboa Monteiro ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Asthma Control ◽  
Control Method ◽  
Inhaled Corticosteroids ◽  
Forced Expiratory Volume ◽  
Control Test ◽  
Asthma Control Test ◽  
Asthmatic Children ◽  
Global Initiative For Asthma ◽  
Global Initiative

Objective: Evaluate the presence of association between the classification of the level of asthma control, using the method proposed by the Global Initiative for Asthma (GINA), the Asthma Control Test (ACT)/Childhood-ACT and the forced expiratory volume in the 1st second (FEV1), in asthmatic children and adolescents treated with inhaled corticosteroids, followed up at the National Institute of Women's, Children's and Adolescents' Health FernandesFigueira of the Oswaldo Cruz Foundation (IFF / FIOCRUZ). Method: A cross-sectional study was carried out with a review of the medical records of all children between 7 and 17 years of age followed up at the Asthma Outpatient Clinic and referred to the Respiratory Insertion Test (PFR) sector between March 2013 and September 2014. In the same day were applied the C-ACT/ACT questionnaires, an asthma control method proposed by the GINA and the FEV1 value in a spirometrictest. Results: From the total number of records evaluated (72), 16 children were excluded because they did not meet the required criteria for performing spirometry. The sample studied (56 children) was predominantly male (58.9%) and median age was 12 (7-17) years. It was observed an association between FEV1 and GINA values ??(p <0.01). Conclusion: The results found in this study indicate that FEV1 measurement is a useful component among the instruments for assessing clinical control of asthma by GINA.

Relationship of the Asthma Control Test (ACT) with Lung Function, Levels of Exhaled Nitric Oxide and Control According to the Global Initiative for Asthma (GINA)

2010 ◽  
Vol 46 (7) ◽  
pp. 370-377 ◽  
Author(s):  
Francisco Javier Álvarez-Gutiérrez ◽  
Juan Francisco Medina-Gallardo ◽  
Pablo Pérez-Navarro ◽  
Juan José Martín-Villasclaras ◽  
Bernardo Martin Etchegoren ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Lung Function ◽  
Asthma Control ◽  
Exhaled Nitric Oxide ◽  
Control Test ◽  
Asthma Control Test ◽  
Global Initiative For Asthma ◽  
Global Initiative ◽  
And Control ◽  
Relationship Of

scholarly journals Clinical effect on uncontrolled asthma using a novel digital automated self-management solution: a physician-blinded randomised controlled crossover trial

2019 ◽  
Vol 54 (5) ◽  
pp. 1900983 ◽  
Author(s):  
Henrik Ljungberg ◽  
Anna Carleborg ◽  
Hilmar Gerber ◽  
Christina Öfverström ◽  
Jakob Wolodarski ◽  
...  
Keyword(s):  
Asthma Control ◽  
Conventional Treatment ◽  
Crossover Trial ◽  
Treatment Plan ◽  
Symptom Control ◽  
Forced Expiratory Volume ◽  
Self Management ◽  
Uncontrolled Asthma ◽  
Asthma Control Test ◽  
Act Score

IntroductionAsthmaTuner is a novel self-management system consisting of a patient app, a cloud-based storage solution and a healthcare interface. Patients use Bluetooth spirometers to measure lung function (forced expiratory volume in 1 s) and can register symptoms. They then receive immediate feedback on asthma control and an image of the correct inhaler(s) to use and the dose. The aim of this pilot study was to evaluate the effect of AsthmaTuner on symptom control and adherence compared with conventional treatment.Material and methodsThis multicentre physician-blinded crossover trial randomised patients in two groups that started with 8 weeks of AsthmaTuner or conventional treatment using a personalised printed treatment plan, with 2 weeks of washout between the crossover treatments. Participants in a primary or paediatric care setting in Sweden with asthma diagnosis, uncontrolled symptoms and Asthma Control Test (ACT) score <20 points were included. Symptom control was analysed using t-tests for the difference between the group means of the sums of ACT scores at each treatment end-visit, with 95% confidence intervals. Medical Adherence Report Scale (MARS) scores captured differences in adherence (remembering to take asthma medication) between treatment periods.ResultsThe study population consisted of 77 patients (60% females). The ACT score significantly improved with AsthmaTuner compared with conventional treatment (mean ACT difference 0.70, 95% CI 0.06–1.34; p=0.03). Adherence did not improve significantly in all participants, but did improve among those in primary care who used AsthmaTuner an average of once a week or more compared with conventional treatment (mean MARS difference 0.45, 95% CI 0.13–0.77; p=0.01).ConclusionsAsthmaTuner improved symptom control in patients with uncontrolled asthma compared with conventional treatment.

scholarly journals Asthma control and its predictors in Ethiopia: Systematic review and meta-analysis

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262566
Author(s):  
Temesgen Mulugeta ◽  
Teshale Ayele ◽  
Getandale Zeleke ◽  
Gebremichael Tesfay
Keyword(s):  
Asthma Control ◽  
Financial Burden ◽  
Meta Analysis ◽  
Symptom Control ◽  
Persistent Asthma ◽  
Uncontrolled Asthma ◽  
Asthma Control Test ◽  
Considerable Heterogeneity ◽  
Asthma Patients

Background Determining the status of asthma control and identifying risk factors for poor asthma control is a key strategy for curbing the negative health impacts and the financial burden of the disease. Therefore, this review was aimed to determine the rate of asthma control and assess the predictors of uncontrolled asthma in Ethiopia. Methods PubMed, Web of Science, and Google Scholar searches were performed using key terms; “asthma, bronchial asthma, control, controlled, uncontrolled and Ethiopia” up to October 16, 2020. University repositories were also searched to retrieve gray literature. The results were presented as a prevalence rate with a 95% confidence interval (CI). Subgroup analysis and meta-regression were performed to identify the sources of heterogeneity in the outcomes. Results From 1,388 patients, based on the Global Initiative for Asthma (GINA) symptom control, the rate of the uncontrolled asthma was 45.0% (95% CI 34.0% - 56.0%) with a considerable heterogeneity between the studies; (I2: 94.55, p< 0.001). About 19.0% (95% CI 10.0% - 29.0%); (I2: 96.04, p< 0.001) of the asthma patients had a well-controlled asthma. Moreover, 36.0% (95% CI 22.0% - 50.0%), (I2: 97.11, p< 0.001) of patients had a partly controlled asthma. Similarly, based on the asthma control test (ACT), the rate of well-controlled asthma was 22.0% (95% CI 3% - 42.0%), with considerable heterogeneity between the studies; (I2: 97.75, p< 0.001). The most frequent predictors of uncontrolled asthma were incorrect inhalation techniques, frequent SABA use, moderate/severe persistent asthma, history of exacerbations, presence of comorbidities, use of oral corticosteroids, and irregular follow-up. Conclusion The rate of uncontrolled asthma in Ethiopia was high. Several factors are associated with uncontrolled asthma. Comprehensive asthma educations at each follow-up visit should be strengthened to minimize the morbidity and the cost of uncontrolled asthma.

INFLUENCE OF NEUTROPHILIC COMPONENT OF BRONCHIAL INFLAMMATION ON THE LEVEL OF DISEASE CONTROL AND LUNG FUNCTION IN PATIENTS WITH ASTHMA

2016 ◽  
Vol 1 (61) ◽  
pp. 16-24 ◽  
Author(s):  
Приходько ◽  
Anna Prikhodko ◽  
Пирогов ◽  
Aleksey Pirogov ◽  
Перельман ◽  
...  
Keyword(s):  
Lung Function ◽  
Asthma Control ◽  
Persistent Asthma ◽  
Close Correlation ◽  
Airway Responsiveness ◽  
Asthma Control Test ◽  
Bronchial Inflammation ◽  
Asthma Patients ◽  
Airway Response ◽  
Mild Persistent Asthma

The cell pattern of bronchi inflammatory infiltrate has a significant impact on the course of the disease and may affect the achievement and maintenance of the asthma control. The aim of the study was to determine the influence of neutrophilic component of the bronchial inflammation on the asthma control, lung function and airway responsiveness. 114 patients with mild persistent asthma were assessed upon the level of the asthma control by Asthma Control Test (ACT); lung function (FEV1) by spirometry; airway responsiveness (∆FEV1) to 3-minute isocapnic hyperventilation with cold air (-20ºС) (IHCA) and 3-minute ultrasound inhalation with distilled water (IDW). The cell composition of the induced sputum (IS) was also studied. The patients were divided into groups with low contents of neutrophils in IS (39 people; 1st group) and with high contents of neutrophils (75 people, 2nd group). The contents of neutrophils in the 1st group was 10.9±0.53%, eosinophils – 19.4±2.1%; in the 2nd group – 29.9±1.6% (р=0.0001) and 20.4±1.4% (р=0.66), respectively. By ACT data the people of the 2nd group managed their disease worse than in 1st group (15.0±0.6 and 19.0±0.8 points, respectively; р=0.0001). They also had lower FEV1 (88.0±2.0 and 96.7±2.4%; р=0.009) and more intensive airway response to IHCA and DW (-13.7±1.7% and -11.2±1.9%, respectively) in comparison with the 1st group (-2.7±0.86%; р=0.0001 and -5.3±1.90%; р=0.055). The patients of the 2nd group had a close correlation between baseline neutrophils in IS and ∆FEV1 in response to IHCA (r=-0.22; р=0.045) as well as the content of myeloperoxidase in IS (r=0.31; р=0.0008). A level of myeloperoxidase in IS correlated with ∆FEV1 in response to IDW (r=0.29; р=0.030) in these patients. The increase of neutrophilic component of inflammation in asthma patients worsens the asthma control, lung function and enhances airway responsiveness to exogenous stimuli.

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