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management of exacerbation of asthma adult

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https://www.readbyqxmd.com/read/29238240/the-effect-of-dpp-4-inhibitors-on-asthma-control-an-administrative-database-study-to-evaluate-a-potential-pathophysiological-relationship
#1
Gene Colice, David Price, Maria Gerhardsson de Verdier, Karma Rabon-Stith, Christopher Ambrose, Katherine Cappell, Debra E Irwin, Paul Juneau, Anna Vlahiotis
Rationale: DPP-4 may regulate immunological pathways implicated in asthma. Assessing whether DPP-4 inhibitor (DPP-4i) use might affect asthma control is clinically important because DPP-4i use in type 2 diabetes mellitus management (T2DM) is increasing. This study evaluated associations between DPP-4i use and asthma control. Methods: This was a retrospective, observational, matched cohort study using administrative claims in the MarketScan® Commercial Claims and Encounters (Commercial) and Medicare Supplemental and Coordination of Benefits (Medicare Supplemental) databases...
2017: Pragmatic and Observational Research
https://www.readbyqxmd.com/read/29207999/corticosteroid-plus-%C3%AE-2-agonist-in-a-single-inhaler-as-reliever-therapy-in-intermittent-and-mild-asthma-a-proof-of-concept-systematic-review-and-meta-analysis
#2
REVIEW
Gang Wang, Xin Zhang, Hong Ping Zhang, Lei Wang, De Ying Kang, Peter J Barnes, Gang Wang
BACKGROUND: Current guidelines recommend a single inhaler maintenance and reliever therapy (SMART) regimen for moderate to severe asthma. However, evidence for the inhaled corticosteroid plus fast-onset-acting β2-agonist (ICS/FABA) as reliever therapy in management of intermittent and mild asthma patients is lacking. OBJECTIVE: To systematically explore efficacy and safety of the proof-of-concept of the ICS plus FABA regimen in a single inhaler as reliever therapy across children and adults with intermittent and mild persistent asthma...
December 6, 2017: Respiratory Research
https://www.readbyqxmd.com/read/29169365/physician-perspectives-on-the-burden-and-management-of-asthma-in-six-countries-the-global-asthma-physician-survey-gaps
#3
Kenneth R Chapman, David Hinds, Peter Piazza, Chantal Raherison, Michael Gibbs, Timm Greulich, Kenneth Gaalswyk, Jiangtao Lin, Mitsuru Adachi, Kourtney J Davis
BACKGROUND: Despite recognition of asthma as a growing global issue and development of global guidelines, asthma treatment practices vary between countries. Several studies have reported patients' perspectives on asthma control. This study presents physicians' perspectives and strategies for asthma management. METHODS: Physicians seeing ≥4 adult patients with asthma per month in Australia, Canada, China, France, Germany, and Japan were surveyed (N=1809; ≈300 per country)...
November 23, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29105786/influenza-burden-prevention-and-treatment-in-asthma-a-scoping-review-by-the-eaaci-influenza-in-asthma-task-force
#4
REVIEW
Jürgen Schwarze, Peter Openshaw, Akhilesh Jha, Stefano R Del Giacco, Davide Firinu, Olympia Tsilochristou, Graham Roberts, Anna Selby, Cezmi Akdis, Ioana Agache, Adnan Custovic, Enrico Heffler, Georgia Pinna, Musa Khaitov, Alexandra Nikonova, Nikolaos Papadopoulos, Ather Akhlaq, Ulugbek Nurmatov, Harald Renz, Aziz Sheikh, Chrysanthi Skevaki
To address uncertainties in the prevention and management of influenza in people with asthma, we performed a scoping review of the published literature on influenza burden; current vaccine recommendations; vaccination coverage; immunogenicity, efficacy, effectiveness and safety of influenza vaccines; and the benefits of antiviral drugs in people with asthma. We found significant variation in the reported rates of influenza detection in individuals with acute asthma exacerbations making it unclear to what degree influenza causes exacerbations of underlying asthma...
November 6, 2017: Allergy
https://www.readbyqxmd.com/read/29101938/practical-considerations-for-the-diagnosis-and-management-of-asthma-in-older-adults
#5
REVIEW
Barbara P Yawn, MeiLan K Han
Although often considered a disease of childhood, the prevalence of asthma in US adults aged 65 years or older is similar to that in children, with the number of older patients needing care for asthma likely to continue to increase. As with most chronic diseases, there are challenges associated with the diagnosis and management of asthma in an older population. This review discusses these challenges, suggesting practical management strategies for primary care physicians and their teams. Asthma comprises a spectrum of phenotypes, some associated with adult onset...
November 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29080708/classification-of-cough-as-a-symptom-in-adults-and-management-algorithms-chest-guideline-and-expert-panel-report
#6
Richard S Irwin, Cynthia L French, Anne B Chang, Kenneth W Altman
BACKGROUND: We performed systematic reviews using the population, intervention, comparison, outcome (PICO) format to answer the following key clinical question: Are the CHEST 2006 classifications of acute, subacute and chronic cough and associated management algorithms in adults that were based on durations of cough useful? METHODS: We used the CHEST Expert Cough Panel's protocol for the systematic reviews and the American College of Chest Physicians (CHEST) methodological guidelines and Grading of Recommendations Assessment, Development, and Evaluation framework...
November 10, 2017: Chest
https://www.readbyqxmd.com/read/29072882/rita-the-italian-severe-uncontrolled-asthma-registry
#7
Sara Maio, Sandra Baldacci, Megon Bresciani, Marzia Simoni, Manuela Latorre, Nicola Murgia, Fabrizio Spinozzi, Mariachiara Braschi, Leonardo Antonicelli, Barbara Brunetto, Patrizia Iacovacci, Paolo Roazzi, Carlo Pini, Mario Pata, Lidia La Grasta, Pierluigi Paggiaro, Giovanni Viegi
BACKGROUND: The Italian severe/uncontrolled asthma (SUA) web-based registry encompasses demographic, clinical, functional, inflammatory data; it aims to raise SUA awareness, identifying specific phenotypes and promoting optimal care. METHODS: 493 adult patients from 27 Italian centres (recruited in 2011-2014) were analyzed. RESULTS: Mean age was 53.8yrs. SUA patients were more frequently female (60.6%), with allergic asthma (83.1%). About 30% showed late onset of asthma diagnosis/symptoms (>40yrs); the mean age for asthma symptoms onset was 30...
October 26, 2017: Allergy
https://www.readbyqxmd.com/read/29071080/description-of-the-protocol-for-the-practical-study-a-randomised-controlled-trial-of-the-efficacy-and-safety-of-ics-laba-reliever-therapy-in-asthma
#8
James Fingleton, Jo Hardy, Christina Baggott, Janine Pilcher, Andrew Corin, Robert J Hancox, Matire Harwood, Mark Holliday, Helen K Reddel, Philippa Shirtcliffe, Suzanne Snively, Mark Weatherall, Richard Beasley
INTRODUCTION: In adult asthma, combination inhaled corticosteroid (ICS)/fast-onset long-acting beta agonist (LABA) used solely as reliever therapy may represent an effective and safe alternative to ICS maintenance and short-acting beta agonist (SABA) reliever therapy. OBJECTIVE: To compare the efficacy and safety of ICS/fast-onset LABA reliever therapy with ICS maintenance and SABA reliever therapy in adults with asthma. METHODS AND ANALYSIS: A 52-week, open-label, parallel group, multicentre, phase III randomised controlled trial with 1:1 randomisation to either budesonide/formoterol Turbuhaler 200/6 µg, one actuation as required for symptom relief, or budesonide Turbuhaler 200 µg, one actuation twice daily and terbutaline Turbuhaler 250 µg, two actuations as required for symptom relief...
2017: BMJ Open Respiratory Research
https://www.readbyqxmd.com/read/29023163/asthma-exacerbations-and-socio-economic-status-in-french-adults-with-persistent-asthma-a-prospective-cohort-study
#9
Katia Mazalovic, Flore Jacoud, Alexandra L Dima, Eric Van Ganse, Maeva Nolin, Didier C, Claire Zaba, The Astro-Lab Group
INTRODUCTION: Adults disadvantaged by poor socio-economic status (SES) are more severely affected by asthma compared to those with better SES. We aimed to determine whether the frequency of asthma exacerbations (AEx), as well as aspects related to AEx management, differed based on SES in patients treated with daily treatments. METHODS: This study, part of the prospective observational cohort ASTRO-LAB, included French adult patients with persistent asthma. Patients were considered as low SES if they benefited from publicly funded special health insurance and/or were perceived as low SES by their general practitioner...
October 12, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28974677/longitudinal-outcomes-of-different-asthma-phenotypes-in-primary-care-an-observational-study
#10
Rishi J Khusial, Jacob K Sont, Rik J B Loijmans, Jiska B Snoeck-Stroband, Pim J J Assendelft, Tjard R J Schermer, Persijn J Honkoop
While asthma presentation is heterogeneous, current asthma management guidelines in primary care are quite homogeneous. In this study we aim to cluster patients together into different phenotypes, that may aid the general practitioner in individualised asthma management. We analysed data from the ACCURATE trial, containing 611 adult asthmatics, 18-50 year-old, treated in primary care, with one year follow-up. Variables obtained at baseline (n = 14), were assessed by cluster analysis. Subsequently, established phenotypes were assessed separately on important asthma outcomes after one year follow-up: asthma control (Asthma Control Questionnaire (ACQ)), quality of life (Asthma Quality of Life Questionnaire (AQLQ)), exacerbation-rate and medication-usage...
October 3, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28972652/shared-decision-making-for-people-with-asthma
#11
REVIEW
Kayleigh M Kew, Poonam Malik, Krishnan Aniruddhan, Rebecca Normansell
BACKGROUND: Asthma is a chronic inflammatory disease that affects the airways and is common in both adults and children. It is characterised by symptoms including wheeze, shortness of breath, chest tightness, and cough. People with asthma may be helped to manage their condition through shared decision-making (SDM). SDM involves at least two participants (the medical practitioner and the patient) and mutual sharing of information, including the patient's values and preferences, to build consensus about favoured treatment that culminates in an agreed action...
October 3, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28931662/-i-have-lost-in-every-facet-of-my-life-the-hidden-burden-of-severe-asthma
#12
Juliet M Foster, Vanessa M McDonald, Michael Guo, Helen K Reddel
People with severe asthma are thought to face a sizeable daily disease burden. This study aimed to explore the little-known life experiences of people living with severe asthma.Adults with severe asthma were invited for telephone interview. Semistructured interviews were conducted until no new themes emerged. The 25 interviews were recorded, transcribed and analysed thematically.Four themes emerged. 1) "The body as a hindrance": severe asthma placed broad limits on life from daily chores to career, relationships and family life that left interviewees feeling emotionally distressed...
September 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28886264/lack-of-asthma-and-rhinitis-control-in-general-practitioner-managed-patients-prescribed-fixed-dose-combination-therapy-in-australia
#13
Sinthia Bosnic-Anticevich, Vicky Kritikos, Victoria Carter, Kwok Yin Yan, Carol Armour, Dermot Ryan, David Price
OBJECTIVES: The first aim of the study (i) assess the current asthma status of general-practitioner-managed patients receiving regular fixed-dose combination inhaled corticosteroid and long-acting beta2 agonist (FDC ICS/LABA) therapy and (ii) explore patients' perceptions of asthma control and attitudes/behaviors regarding preventer inhaler use. METHODS: A cross-sectional observational study of Australian adults with a current physician diagnosis of asthma receiving ≥2 prescriptions of FDC ICS/LABA therapy in the previous year, who were recruited through general practice to receive a structured in-depth asthma review between May 2012 and January 2014...
September 8, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28800273/assessing-the-impact-of-a-remote-digital-coaching-engagement-program-on-patient-reported-outcomes-in-asthma
#14
Mazi Rasulnia, Billy Stephen Burton, Robert P Ginter, Tracy Y Wang, Roy Alton Pleasants, Cynthia L Green, Njira Lugogo
BACKGROUND: Low adherence and poor outcomes provide opportunity for digital coaching to engage patients with uncontrolled asthma in their care to improve outcomes. OBJECTIVE(S): To examine the impact of a remote digital coaching program on asthma control and patient experience. METHODS: We recruited 51 adults with uncontrolled asthma, denoted by albuterol use of >2 times per week and/or exacerbations requiring corticosteroids, and applied a 12-week patient-centered remote digital coaching program using a combination of educational pamphlets, symptom trackers, best peak flow establishment, physical activity, and dietary counseling, as well as coaches who implemented emotional enforcement to motivate disease self-management through telephone, text, and email...
August 11, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28733686/comparison-of-the-proportion-and-healthcare-utilisation-of-adult-patients-with-uncontrolled-severe-asthma-versus-non-severe-asthma-seen-in-a-southeast-asian-hospital-based-respiratory-specialist-clinic
#15
Tunn Ren Tay, Hang Siang Wong, Rosna Ihsan, Hsiao Peng Toh, Xuening Choo, Augustine Kh Tee
INTRODUCTION: Understanding the burden of uncontrolled severe asthma is essential for disease-targeted healthcare planning. There is a scarcity of data regarding the proportion, healthcare utilisation and costs of patients with uncontrolled severe asthma in Asia. This study aimed to plug the knowledge gap in this area. MATERIALS AND METHODS: Consecutive patients with asthma managed in our respiratory specialist clinic were evaluated prospectively. Healthcare utilisation comprising unscheduled asthma-related primary care visits, emergency department (ED) visits and hospital admissions were obtained from the national health records system...
June 2017: Annals of the Academy of Medicine, Singapore
https://www.readbyqxmd.com/read/28728272/-the-level-of-asthma-control-in-china-from-a-national-asthma-control-survey
#16
J T Lin, W Q Wang, X Zhou, C Z Wang, M Huang, S X Cai, P Chen, Q C Lin, J Y Zhou, Y H Gu, Y D Yuan, D J Sun, X H Yang, L Yang, J M Huo, Z C Chen, P Jiang, J Zhang, X W Ye, H G Liu, H P Tang, R Y Liu, C T Liu, W Zhang, C P Hu, Y Q Chen, X J Liu, L M Dai, W Zhou, Y J Huang, J Y Xu
Objective: To assess the overall asthma control level in urban China. Methods: A multi-center, cross-sectional, questionnaire-based survey was carried out in 30 provinces in China (except Tibet). Asthmatic outpatients who met the inclusion criteria were recruited consecutively from 30 sub-centers from October 2015 to May 2016. Data of demographic characteristics, asthma control, asthma management, asthma exacerbations and self-management, and disease perception were collected by face-to-face interviews. Results: Totally 3 875 asthmatic outpatients were recruited...
July 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28721017/targeted-therapy-in-severe-asthma-today-focus-on-immunoglobulin-e
#17
REVIEW
Girolamo Pelaia, Giorgio Walter Canonica, Andrea Matucci, Rossella Paolini, Massimo Triggiani, Pierluigi Paggiaro
Asthma is a complex chronic inflammatory disease of multifactorial etiology. International guidelines increasingly recognize that a standard "one size fits all" approach is no longer an effective approach to achieve optimal treatment outcomes, and a number of disease phenotypes have been proposed for asthma, which has the potential to guide treatment decisions. Among the many asthma phenotypes, allergic asthma represents the widest and most easily recognized asthma phenotype, present in up to two-thirds of adults with asthma...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28677351/positioning-of-long-acting-muscarinic-antagonists-in-the-management-of-asthma
#18
REVIEW
René Aalbers, Hae Sim Park
Despite a range of efficacious therapies for asthma, including inhaled corticosteroids (ICS) and long-acting β₂-agonists (LABA), a significant proportion of patients have poor asthma control and retain a risk of future worsening of their symptoms. Long-acting muscarinic antagonist (LAMA) bronchodilators offer a well-tolerated, efficacious, and cost-effective add-on to a patient's treatment. Of the LAMAs currently under investigation or available for the treatment of asthma, evidence from a comprehensive clinical trial program in adults and children shows that once-daily treatment with tiotropium provides benefits for patients with uncontrolled asthma despite the use of ICS and LABAs...
September 2017: Allergy, Asthma & Immunology Research
https://www.readbyqxmd.com/read/28669892/validity-of-the-asthma-control-test-questionnaire-among-smoking-asthmatics
#19
Xavier Soler, Janet T Holbrook, Lynn B Gerald, Cristine E Berry, Joy Saams, Robert J Henderson, Elizabeth Sugar, Robert A Wise, Joe W Ramsdell
BACKGROUND: Smoking asthmatics respond worse to existing asthma therapies and have more asthma symptoms and exacerbations. OBJECTIVE: We evaluated the Asthma Control Test (ACT) for assessing asthma control among smokers. METHODS: Adults with asthma who smoked were enrolled and followed for 6 weeks. The statistical properties, validity, and responsiveness of the ACT were evaluated. Physician global assessment (GS) of asthma was the "gold standard...
June 29, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28583260/the-case-for-impulse-oscillometry-in-the-management-of-asthma-in-children-and-adults
#20
REVIEW
Stanley P Galant, Hirsh D Komarow, Hye-Won Shin, Salman Siddiqui, Brian J Lipworth
OBJECTIVE: To provide a clinical rationale for including impulse oscillometry (IOS) as a part of standard office-based asthma assessment. DATA SOURCES: PubMed and Google search, limited to English language and human disease, with the keywords IOS and asthma. STUDY SELECTIONS: Articles included in this review were based on the expert opinion and previous publications by the authors. RESULTS: In children, IOS was more useful than spirometry in identifying asthma and uncontrolled asthma and predicting loss of control and exacerbations...
June 2017: Annals of Allergy, Asthma & Immunology
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