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 control level in Finland among asthmatics with smoking history: a cross-sectional study

2020 ◽  
Author(s):  
Timo Helin
Keyword(s):  
Primary Care ◽  
Asthma Control ◽  
Smoking Status ◽  
Control Level ◽  
Cross Sectional Study ◽  
Smoking History ◽  
Uncontrolled Asthma ◽  
Cross Sectional ◽  
Asthmatic Patients ◽  
Gina Guidelines

Abstract Surprisingly little is known about asthma control level of smoking asthmatics. The aim of this study was to investigate asthma control level, according to GINA guidelines, among asthmatics with smoking history.One hundred and ninety asthmatics from primary care were investigated. The patients were current or ex-smokers with history of 10 or more pack-years. They completed a questionnaire, with questions set according to the GINA guidelines, so that their asthma control level (well controlled, partly controlled, uncontrolled) according to GINA could be determined.According to GINA guidelines, 66 (34.7%) patients had their asthma well controlled, 81 (42.6%) had their asthma partly controlled, and 43 (22.6%) were uncontrolled. Current smokers had more often uncontrolled asthma than ex-smokers OR 2.54 (95%CI 1.25-5.14, p=0.01). Patients with asthma exacerbation during the previous year had uncontrolled asthma more often than the patients without exacerbation OR 2.17 (95%CI 1.06-4.47, p=0.04), and patients with FEV1 < 80% of predicted had their asthma more often uncontrolled than patients with FEV1 > 80% of predicted OR 2.04 (95%CI 1.02-4.08, p=0.04).Primary care asthmatic patients who are either current or ex-smokers, are often not well controlled. The asthma control level was associated with current smoking status. Therefore, every attempt should be made to get smoking asthmatics to quit smoking.

scholarly journals Cartography of Emergency Department Visits for Asthma – Targeting High-Morbidity Populations

2004 ◽  
Vol 11 (6) ◽  
pp. 427-433 ◽  
Author(s):  
Pierre Lajoie ◽  
Andrée Laberge ◽  
Germain Lebel ◽  
Louis-Philippe Boulet ◽  
Marie Demers ◽  
...  
Keyword(s):  
Emergency Department ◽  
Emergency Department Visits ◽  
Administrative Database ◽  
Chronic Obstructive ◽  
High Morbidity ◽  
Age Group ◽  
Obstructive Pulmonary Disease ◽  
Asthmatic Patients ◽  
South Central ◽  
Ed Visits

BACKGROUND:Asthma education should be offered with priority to populations with the highest asthma-related morbidity. In the present study, the aim was to identify populations with high-morbidity for asthma from the Quebec Health Insurance Board Registry, a large administrative database, to help the Quebec Asthma and Chronic Obstructive Pulmonary Disease Network target its interventions.METHODS:All emergency department (ED) visits for asthma were analyzed over a one-year period, considering individual and medical variables. Age- and sex-adjusted rates, as well as standardized rate ratios related to the overall Quebec rate, among persons zero to four years of age and five to 44 years of age were determined for 15 regions and 163 areas served by Centres Locaux de Services Communautaires (CLSC). The areas with rates 50% to 300% higher (P<0.01) than the provincial rate were defined as high-morbidity areas. Maps of all CLSC areas were generated for the above parameters.RESULTS:There were 102,551 ED visits recorded for asthma, of which more than 40% were revisits. Twenty-one CLSCs and 32 CLSCs were high-morbidity areas for the zero to four years age group and five to 44 years age group, respectively. For the most part, the high-morbidity areas were located in the south-central region of Quebec. Only 47% of asthmatic patients seen in ED had also seen a physician in ambulatory care.CONCLUSION:The data suggest that a significant portion of the population seeking care at the ED is undiagnosed and undertreated. A map of high-morbidity areas that could help target interventions to improve asthma care and outcomes is proposed.

scholarly journals Hubungan Kadar Periostin Serum dan Nilai Asthma Control Test pada Pasien Asma di RSUD Dr. Soetomo Surabaya

2018 ◽  
Vol 4 (2) ◽  
pp. 33
Author(s):  
Ni Made Dwita Yaniswari ◽  
Muhammad Amin
Keyword(s):  
Asthma Control ◽  
Matrix Protein ◽  
Extracellular Matrix Protein ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Test ◽  
Uncontrolled Asthma ◽  
Asthma Control Test ◽  
Asthmatic Patients ◽  
Act Score ◽  
Serum Periostin

Background: Asthma is a heterogenous disease composed of various phenotype. Chronic airway inflammation are fundamental features of asthma. The main treatment of asthma is corticosteroid. The administration of inhaled corticosteroids will reduce the inflammatory process in asthma. Even with adequate inhaled corticosteroid treatment, there are still patients who develop symptoms with lower asthma control test score. Periostin is an extracellular matrix protein as the best single systemic biomarker for assessing tissue eosinophilia, airway remodeling in uncontrolled asthma. The objective of this study was to examine whether serum periostin is correlated with ACT in asthmatic patients. Methods: This research was an observational analytical with cross sectional design conducted in outpatient clinic Dr. Soetomo General Hospital Surabaya for 3 months. In total, we found 40 asthmatic patients who were qualified to the inclusion and exclusion criteria as the research samples.  The questionnaire was filled in to assess the Asthma Control Test and venous blood tests to measure serum periostin levels using Sandwich Enzyme-Linked Immunosorbent Assay (ELISA) method. Results: The mean periostin level profile of the sample was 94.82 ± 19.21 ng/ml and the median was 94.7 ng/ml. The average ACT score was 16.55 ± 2.93 with 85% were uncontrolled asthma. The results of the independent t-test showed serum periostin levels and the level of asthma control based on ACT score in asthmatics patients had a significant correlation (p = 0.024). Conclusion: There is a significant correlation between serum periostin levels and ACT score in asthmatic patients.

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 prevalence of sleep disturbance among asthmatic patients in a tertiary care center

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Tammam M. Alanazi ◽  
Hazim S. Alghamdi ◽  
Meshal S. Alberreet ◽  
Abdulaziz M. Alkewaibeen ◽  
Abdulrahman M. Alkhalefah ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Quality ◽  
Sleep Disturbance ◽  
Asthma Control ◽  
Poor Sleep ◽  
Uncontrolled Asthma ◽  
Poor Sleep Quality ◽  
Asthmatic Patients ◽  
Obstructive Sleep ◽  
Asthma Patients

AbstractSleep disturbances are commonly reported by patients with asthma. However, the prevalence of sleep disturbance and its association with the level of asthma control is unknown. The primary objective was to determine the prevalence of sleep disturbance among Saudi adult asthmatic patients attending pulmonary clinics at King Abdulaziz Medical City (KAMC). The study also aimed to compare sleep quality between controlled and uncontrolled asthma patients. The study was carried out in the outpatient pulmonary clinics at KAMC and utilized a cross-sectional survey. The survey included five different questionnaires: asthma control test and questionnaires related to the quality of sleep (Pittsburgh sleep quality index [PSQI], Epworth sleepiness scale [ESS], Berlin questionnaire [a measure of obstructive sleep apnea risk], and insomnia severity index [ISI]). Among the 200 asthma patients, 66% suffered from poor sleep quality (PSQI > 5), 43% were at high risk for obstructive sleep apnea, 25% had excessive daytime sleepiness (ESS > 10), and 46.5% had significant clinical insomnia (ISI ≥ 10). Poor sleep quality was less common in patients with well-controlled asthma (37%) compared to those with partially controlled asthma (78%) and uncontrolled asthma (82%) (p < 0.001). Poor sleep quality was common among patients with asthma, particularly those with suboptimal levels of asthma control. Further studies are needed to better understand the interaction between these two conditions.

scholarly journals Indicators of Asthma Control in Asthmatic Patients: Are they related to Depression?

2017 ◽  
Vol 5 (5) ◽  
pp. 673-676 ◽  
Author(s):  
Tarig H. Merghani ◽  
Azza O. Alawad
Keyword(s):  
Asthma Control ◽  
Statistical Significance ◽  
Significant Proportion ◽  
Bipolar Disorders ◽  
Clinical Depression ◽  
Uncontrolled Asthma ◽  
Asthma Control Test ◽  
Chi Square ◽  
Asthmatic Patients ◽  
The Poor

BACKGROUND: Many patients with chronic illnesses suffer from depression. A poorly controlled asthma that presents with repeated attacks of breathlessness is a recognised risk factor for bipolar disorders. On the other hand, depression can aggravate asthma symptoms.AIM: The aim of this study is to determine the indicators of the asthma control test (ACT) among the asthmatic patients who attend the outpatient clinic for follow-up and to investigate the relation between these indicators and clinical depression, using a standardised depression scale.METHODS: A total of 38 adult asthmatic patients (29 women, age 17–85 years), with variable levels of control, were assessed using the ACT and the Beck Depression Inventory (BDI). Data obtained were analysed with the Statistical Package for the Social Sciences (SPSS Inc., Chicago, IL, USA) version 20. The association of depression with the various indicators of asthma control was analysed with the Chi-Square test. Statistical significance was determined at p< 0.05.RESULTS: The uncontrolled asthma is associated with depression in 37% of all participants compared to 0% in the well-controlled group (p = 0.002). Depression is significantly related to asthma interference with daily activities (p = 0.003), breathlessness (p < 0.001), night symptoms (p = 0.036), use of bronchodilators (p = 0.007), and poor compliance with medical treatment (p = 0.003). The poor educational attainment and comorbidities have significant relations to both uncontrolled asthma and clinical depression (p < 0.05).CONCLUSION: All indicators of the poor asthma control are associated with clinical depression. A significant proportion of the uncontrolled asthma patients suffers from depression. The possibility of improving asthma control with a pharmacological treatment of depression has to be considered.

scholarly journals Montelukast as Add-On Therapy to Inhaled Corticosteroids in the Management of Asthma (the SAS trial)

2009 ◽  
Vol 16 (suppl a) ◽  
pp. 5A-10A ◽  
Author(s):  
J Mark Fitzgerald ◽  
Sylvain Foucart ◽  
Stephen Coyle ◽  
John Sampalis ◽  
Denis Haine ◽  
...  
Keyword(s):  
Asthma Control ◽  
Inhaled Corticosteroids ◽  
Inhaled Corticosteroid ◽  
Uncontrolled Asthma ◽  
Open Label ◽  
Asthma Control Questionnaire ◽  
Asthmatic Patients ◽  
The Mean ◽  
Clinically Significant ◽  
High Doses

AIM: To evaluate the effectiveness of montelukast as add-on therapy for asthmatic patients who remain uncontrolled with low, moderate or high doses of inhaled corticosteroid monotherapy.DESIGN: An eight-week, multicentre, open-label, observational study.RESULTS: Of 320 patients enrolled, 288 (90.0%) completed the study. Of patients who had uncontrolled asthma symptoms (Canadian Asthma Consensus Guidelines Update, 2003) but were controlled according to the Asthma Control Questionnaire (ACQ score of less than 1.5), 93.9% maintained asthma control at week 8. Of patients with uncontrolled asthma at baseline for both definitions, 63.5% achieved asthma control by week 8. The mean ± SD ACQ score decreased from 1.13±0.28 to 0.57±0.50 (P<0.001) for controlled patients at baseline and from 2.38±0.73 to 1.03±0.80 (P<0.001) for patients who were uncontrolled at baseline, each representing a clinically significant improvement.CONCLUSION: Montelukast add-on therapy is an effective alternative to inhaled corticosteroid monotherapy.

scholarly journals Combination of Fractional Exhaled Nitric Oxide (FeNO) Level and Asthma Control Test (ACT) in Detecting GINA-Defined Asthma Control in Treated Asthmatic Patients in Vietnam

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Vinh Nguyen Nhu ◽  
Pham Le An ◽  
Niels H. Chavannes
Keyword(s):  
Asthma Control ◽  
Roc Curve ◽  
Medical Center ◽  
Asthma Management ◽  
Cross Sectional Study ◽  
Uncontrolled Asthma ◽  
Roc Curve Analysis ◽  
Asthma Control Test ◽  
Cross Sectional ◽  
Asthmatic Patients

Background. FeNO has been used as a marker for Th2-mediated airway inflammation in asthma. There is evidence which recommends the use of this biomarker in asthma management. Little is known about whether the FeNO test alone or in combination with the ACT score can reflect asthma control in Vietnamese patients. Materials and Methods. A cross-sectional study was conducted in asthmatic patients (≥18 years old) recruited at the University Medical Center, Ho Chi Minh City, Vietnam from March 2016 to March 2017. Asthma control levels were assessed following the GINA 2017 guidelines, and FeNO was measured by a Niox Mino device. FeNO cut-offs predicting asthma control status were determined using the ROC curve analysis. The combination of FeNO and ACT was investigated in detecting well-controlled and uncontrolled asthma. The results of the study are as follows: 278 patients with 68% females, mean age of 44 years, and mean asthma duration of 10 years were analyzed. All patients were treated following step 2 to 4 of GINA guidelines. Mean (SD) FeNO was 30.6 (24) ppb. Patients with uncontrolled (16%), partly controlled (29%), and well-controlled asthma (55%) had a median (IQR) FeNO of 50.0 (74), 25.0 (23), and 21.0 (22.3) ppb, respectively, and the mean of FeNO in the uncontrolled group was significantly higher than that in other groups (p<0.001). The area under the ROC curve (AUC) for FeNO detecting uncontrolled asthma was 0.730 with an optimal cut-off point of FeNO > 50 ppb, and this AUC increased to 0.89 when combining FeNO and ACT. The AUC for FeNO detecting well-controlled asthma was 0.601 with an optimal cut-off point of FeNO <25 ppb and this AUC increased to 0.78 if combining FeNO and ACT. Conclusions. FeNO can predict asthma control status with an estimated cut-off point of <25 ppb for well-controlled and >50 ppb for uncontrolled asthma. The combination of FeNO and ACT provides better information regarding asthma control than FeNO alone, and this combination is useful to predict asthma control statuses in asthmatic patients in Viet Nam.

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