scholarly journals Respiratory Adherence Care Enhancer Questionnaire: Identifying Self-Management Barriers of Inhalation Corticosteroids in Asthma

2021 ◽  
Vol 12 ◽  
Author(s):  
Claire D. Visser ◽  
Jip M. Linthorst ◽  
Esther Kuipers ◽  
Jacob K. Sont ◽  
Joyca P. W. Lacroix ◽  
...  
Keyword(s):  
Inhaled Corticosteroids ◽  
Theoretical Domains Framework ◽  
Cross Sectional Study ◽  
Individual Variability ◽  
Self Management ◽  
Expert Assessment ◽  
Cross Sectional ◽  
Asthma Patients ◽  
Golden Standard ◽  
Behavioral Barriers

Introduction: Suboptimal self-management of inhaled corticosteroids (ICS) in asthma patients is frequently observed in clinical practice and associated with poor asthma control. Driving factors for suboptimal self-management are complex and consist of a range of behavioral barriers (cognitive, affective and practical) with a considerable inter-individual variability. Identification of individual barriers facilitates the use of corresponding behavior change techniques and tailored care to improve asthma treatment outcomes.Objective: This study describes the development and validation of the ‘Respiratory Adherence Care Enhancer’ (RACE) questionnaire to identify individual barriers to self-management of ICS therapy in asthma patients.Methods: The development included: 1) an inventory of self-management barriers based on a literature review, 2) expert assessment on relevance and completeness of this set, linking these barriers to behavioral domains of the Theoretical Domains Framework (TDF) and 3) the formulation of corresponding questions assessing each of the barriers. A cross-sectional study was performed for validation. Primary care asthma patients were invited to fill out the RACE-questionnaire prior to a semi-structured telephonic interview as golden standard. Barriers detected from the questionnaire were compared to those mentioned in the interview.Results: The developed questionnaire is made up of 6 TDF-domains, covering 10 self-management barriers with 23 questions. For the validation 64 patients completed the questionnaire, of whom 61 patients were interviewed. Cronbach’s alpha for the consistency of questions within the barriers ranged from 0.58 to 0.90. Optimal cut-off values for the presence of barriers were determined at a specificity between 67 and 92% with a sensitivity between 41 and 83%. Significant Areas Under the Receiver Operating Curves values were observed for 9 barriers with values between 0.69 and 0.86 (p-value <0.05), except for ‘Knowledge of ICS medication’ with an insignificant value of 0.53.Conclusion: The RACE-questionnaire yields adequate psychometric characteristics to identify individual barriers to self-management of ICS therapy in asthma patients, facilitating tailored care.

A Cross-Sectional Evaluation of Illness Perception About Asthma Among Asthma Patients at a Referral Tertiary Care Public Chest Hospital in Delhi, India

2012 ◽  
Vol 2 (3) ◽  
pp. 32-43
Author(s):  
Sushil Shendge ◽  
Barnali Deka ◽  
Anita Kotwani
Keyword(s):  
Inhaled Corticosteroids ◽  
Tertiary Care ◽  
Illness Perception ◽  
Clinical History ◽  
Self Management ◽  
Cross Sectional ◽  
The Public ◽  
Co Morbidity ◽  
Asthma Patients ◽  
History Of

Adult patients visiting emergency room (March 2009-December 2009) of the public chest hospital for asthma exacerbation completed interviewer-administered questionnaires on sociodemographics, clinical history, disease beliefs, use of inhaled corticosteroids (ICS), and self-management of asthma after stabilization of their condition. Overall 87% patients believed that they had asthma when they are having symptoms, which is called as no symptoms, no asthma belief. No association was found between no symptoms, no asthma belief with gender, income, family history of asthma, and co-morbidity. Younger patients in the age group 18-29 years had four to five-fold greater odds and patients with education above 10th grade had three to four-fold greater odds of having the no symptoms, no asthma belief or the acute episodic belief. Acute episodic belief was negatively associated with beliefs about always having asthma, asthma being a serious condition, having lung inflammation, or the importance of using ICS, and was positively associated with expecting to be cured. All patients irrespective of their belief of acute or chronic nature of asthma had poor adherence to the treatment and other self-management behaviors.

scholarly journals Systemic adverse events from inhaled corticosteroids self-reported by asthma patients: A “real-life” cross sectional study

2016 ◽  
Vol 22 (4) ◽  
pp. 243-245
Author(s):  
C.R. Pinto ◽  
A.C.M. Lemos ◽  
A.T. de Alcantara ◽  
P.M.C. de Oliveira ◽  
A.C.T. do Vale ◽  
...  
Keyword(s):  
Adverse Events ◽  
Inhaled Corticosteroids ◽  
Real Life ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Asthma Patients

scholarly journals Local adverse effects associated with the use of inhaled corticosteroids in patients with moderate or severe asthma

2013 ◽  
Vol 39 (4) ◽  
pp. 409-417 ◽  
Author(s):  
Charleston Ribeiro Pinto ◽  
Natalie Rios Almeida ◽  
Thamy Santana Marques ◽  
Laira Lorena Lima Yamamura ◽  
Lindemberg Assuncao Costa ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Severe Asthma ◽  
Inhaled Corticosteroids ◽  
Oral Candidiasis ◽  
Control Program ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Throat Clearing ◽  
Asthma Patients

OBJECTIVE: To describe and characterize local adverse effects (in the oral cavity, pharynx, and larynx) associated with the use of inhaled corticosteroids (ICSs) in patients with moderate or severe asthma. METHODS: This was a cross-sectional study involving a convenience sample of 200 asthma patients followed in the Department of Pharmaceutical Care of the Bahia State Asthma and Allergic Rhinitis Control Program Referral Center, located in the city of Salvador, Brazil. The patients were ≥ 18 years of age and had been using ICSs regularly for at least 6 months. Local adverse effects (irritation, pain, dry throat, throat clearing, hoarseness, reduced vocal intensity, loss of voice, sensation of thirst, cough during ICS use, altered sense of taste, and presence of oral candidiasis) were assessed using a 30-day recall questionnaire. RESULTS: Of the 200 patients studied, 159 (79.5%) were women. The mean age was 50.7 ± 14.4 years. In this sample, 55 patients (27.5%) were using high doses of ICS, with a median treatment duration of 38 months. Regarding the symptoms, 163 patients (81.5%) reported at least one adverse effect, and 131 (65.5%) had a daily perception of at least one symptom. Vocal and pharyngeal symptoms were identified in 57 (28.5%) and 154 (77.0%) of the patients, respectively. The most commonly reported adverse effects were dry throat, throat clearing, sensation of thirst, and hoarseness. CONCLUSIONS: Self-reported adverse effects related to ICS use were common among the asthma patients evaluated here.

scholarly journals The usefulness of competitive PCR: airway gene expression of IL-5, IL-4, IL-4δ2, IL-2, and IFNγ in asthma

Thorax ◽  
2001 ◽  
Vol 56 (7) ◽  
pp. 541-548
Author(s):  
E M Glare ◽  
M Divjak ◽  
M J Bailey ◽  
E H Walters
Keyword(s):  
Gene Expression ◽  
Inhaled Corticosteroids ◽  
In Situ Hybridisation ◽  
Housekeeping Gene ◽  
Cross Sectional Study ◽  
Mrna Levels ◽  
Competitive Pcr ◽  
Cross Sectional ◽  
Steroid Use ◽  
Biopsy Specimens

BACKGROUNDAsthma has been described as an eosinophilic bronchitis driven by interleukin(IL)-4 and IL-5. The quantification of cytokine mRNA levels in airway samples has been confounded by housekeeping gene expression which differs between and within asthmatics and controls.METHODSThe usefulness of competitive reverse transcriptase-polymerase chain reaction (RT-PCR) that is independent of housekeeping gene expression for quantitating the mRNA for interferon (IFN)γ, IL-2, IL-5, IL-4 and its receptor antagonist encoding splicing variant IL-4δ2 was determined in a cross sectional study of 45 normal control subjects and 111 with asthma.RESULTSAtopic controls and atopic asthmatic subjects expressed more IL-5 than non-atopic controls (p<0.02) in bronchoalveolar lavage (BAL) cells, but not in biopsy specimens. IL-5 mRNA expression in BAL cells from asthmatic subjects using inhaled corticosteroids (ICS) was significantly lower than those not receiving ICS (p=0.04). IL-2 mRNA levels differed with steroid use in biopsy specimens but not in BAL cells. IFNγ, IL-4, and IL-4δ2 mRNA levels did not differ between any groups and were not affected by steroid use. IL-4 and IL-4δ2 mRNA levels were positively correlated (p<0.0001), suggesting coordinated transcription.CONCLUSIONSWhile the signal differentiation of competitive PCR in asthma may rival that of in situ hybridisation and immunohistochemistry, the method is expensive and wasteful of material.

scholarly journals Children’s Experiences of Their Journey to School: Integrating Behaviour Change Frameworks to Inform the Role of the Built Environment in Active School Travel Promotion

2021 ◽  
Vol 18 (9) ◽  
pp. 4992
Author(s):  
Nafsika Michail ◽  
Ayse Ozbil ◽  
Rosie Parnell ◽  
Stephanie Wilkie
Keyword(s):  
Behaviour Change ◽  
Primary Schools ◽  
Theoretical Domains Framework ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
School Travel ◽  
Cross Sectional ◽  
Active School Travel ◽  
Affective Experiences

Childhood obesity is a public health problem with multiple effects on children’s life. Promoting Active School Travel (AST) could provide an inclusive opportunity for physical activity and shape healthy behaviours. Data for this cross-sectional study were drawn from questionnaires carried out in five primary schools located in Newcastle upon Tyne, UK, in neighbourhoods chosen for their variability in IMD (index of multiple deprivation) and spatial structure of street networks (measured through space syntax measure of integration). A randomly selected and heterogenic sample of 145 pupils (aged 9–10) completed an open-ended questionnaire to state what they like and dislike about their journey to school. Thematic analysis identified four typologies (environmental context, emotions, social influences and trip factors) based on the Theoretical Domains Framework (TDF) and specific themes and sub-themes underlying children’s affective experiences of their journeys to school. This study is the first known to authors to attempt to adapt the Capability, Opportunity and Motivation Behaviour (COM-B) model into AST and children’s experiences and associated behavioural domains with design aspects. Such an insight into children’s attitudes could inform urban planners and designers about how to apply more effective behaviour change interventions, targeting an AST increase among children.

scholarly journals Higher Omega-3 Index Is Associated with Better Asthma Control and Lower Medication Dose: A Cross-Sectional Study

Nutrients ◽  
2019 ◽  
Vol 12 (1) ◽  
pp. 74 ◽  
Author(s):  
Isobel Stoodley ◽  
Manohar Garg ◽  
Hayley Scott ◽  
Lesley Macdonald-Wicks ◽  
Bronwyn Berthon ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Asthma Control ◽  
Inhaled Corticosteroids ◽  
Asthma Management ◽  
Airway Disease ◽  
Cross Sectional Study ◽  
Erythrocyte Membranes ◽  
Omega 3 ◽  
Asthma Control Questionnaire ◽  
Cross Sectional

Asthma is a chronic inflammatory airway disease, associated with systemic inflammation. Omega-3 polyunsaturated fatty acids (n-3 PUFA) have established anti-inflammatory effects, thus having potential as an adjunct therapy in asthma. This study aimed to compare erythrocyte n-3 PUFA in adults with (n = 255) and without (n = 137) asthma and determine the relationship between erythrocyte n-3 PUFA and clinical asthma outcomes. Subjects had blood collected, lung function measured and Juniper Asthma Control Questionnaire (ACQ) score calculated. Fatty acids were measured in erythrocyte membranes by gas chromatography, and the omega-3 index (O3I) was calculated (% eicosapentaenoic acid + % docosahexaenoic acid). O3I was similar in subjects with and without asthma (p = 0.089). A higher O3I was observed in subjects with controlled or partially controlled asthma (ACQ < 1.5) compared to subjects with uncontrolled asthma (ACQ ≥ 1.5) (6.0% (5.4–7.2) versus 5.6% (4.6–6.4) p = 0.033). Subjects with a high O3I (≥8%) had a lower maintenance dose of inhaled corticosteroids (ICS) compared to those with a low O3I (<8%) (1000 μg (400–1000) versus 1000 μg (500–2000) p = 0.019). This study demonstrates that a higher O3I is associated with better asthma control and with lower ICS dose, suggesting that a higher erythrocyte n-3 PUFA level may have a role in asthma management.

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