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"Asthma control"

Ashutosh N Aggarwal, Raman Kumari, Sandeep Grover
BACKGROUND: We sought to compare treatment satisfaction with inhaled medications among asthmatics using a metered-dose inhaler (MDI) or a dry-powder inhaler (DPI), and to correlate satisfaction with treatment adherence, pulmonary function, and airway inflammation. METHODS: Spirometry, fraction of expired nitric oxide (FENO ), and asthma control were assessed in 200 adult subjects with asthma (69 men, 131 women) using MDI or DPI. Treatment satisfaction with inhaled therapy was assessed with the Treatment Satisfaction Questionnaire for Medication (TSQM) in 4 domains: Effectiveness, Side Effects, Convenience, and Global Satisfaction...
March 20, 2018: Respiratory Care
Selene Valero-Moreno, Marián Pérez-Marín, Inmaculada Montoya-Castilla, Silvia Castillo-Corullón, Alvar Ramírez-Aguilar, Amparo Escribano-Montaner
INTRODUCTION: Adolescents with asthma face problems inherent to this stage in their development, to which the challenges of taking over control of their disease, complying with a daily treatment and regular medical followup are added. Any rejection generated by this may lead to treatment non-adherence and poor asthma control, which brings about problems in family dynamics, made worse by the stress or the emotional distress that this situation causes in caregivers. OBJECTIVE: Identify adjustment profiles and predictors of risk for the well-being of caregivers of pediatric patients with bronchial asthma...
April 1, 2018: Archivos Argentinos de Pediatría
Verónica Giubergia, María J Ramirez Farías, Verónica Pérez, Adriana González, Nancy Crespi, Nora Fridman, Claudio Castaños
INTRODUCTION: Severe asthma accounts for 5-7% of all asthma cases. The World Health Organization proposed a follow-up protocol to classify cases into severe, treatment-resistant asthma (STRA) or severe, difficult-to-control asthma (SDCA). OBJECTIVE: To analyze the clinical, functional, and therapeutic characteristics of patients with STRA or SDCA. METHODS: Cross-sectional, observational, and analytical study to assess the diagnosis, the extent of control (clinical and functional), comorbidities, treatment adherence, inhalation technique, and environmental factors in patients with severe asthma...
April 1, 2018: Archivos Argentinos de Pediatría
Rolandas Urbstonaitis, Maithili Deshpande, Jennifer Arnoldi
BACKGROUND: Health related quality of life (HRQoL) reflects the impact of a chronic disease, such as asthma, from a patient perspective. Late midlife adults (50-64 years) have been identified by the Centers for Disease Control & Prevention as an important population for healthy aging. OBJECTIVES: To evaluate the factors associated with HRQoL among late midlife adults with asthma. METHODS: This study utilized data from 2012 to 2013 Behavioral Risk Factor Surveillance System Asthma Call Back Survey...
March 9, 2018: Research in Social & Administrative Pharmacy: RSAP
Diana M Sobieraj, William L Baker, Elaine Nguyen, Erin R Weeda, Craig I Coleman, C Michael White, Stephen C Lazarus, Kathryn V Blake, Jason E Lang
Importance: Long-acting muscarinic antagonists (LAMAs) are a potential adjunct therapy to inhaled corticosteroids in the management of persistent asthma. Objective: To conduct a systematic review and meta-analysis of the effects associated with LAMA vs placebo or vs other controllers as an add-on therapy to inhaled corticosteroids and the use of a LAMA as add-on therapy to inhaled corticosteroids and long-acting β-agonists (LABAs; hereafter referred to as triple therapy) vs inhaled corticosteroids and LABA in patients with uncontrolled, persistent asthma...
March 19, 2018: JAMA: the Journal of the American Medical Association
Nathan D Shippee, Michael Finch, Douglas R Wholey
OBJECTIVES: Patient-centered medical homes (PCMHs) represent a widespread model of healthcare transformation. Despite evidence that PCMHs can improve care quality, the mechanisms by which they improve outcomes are relatively unexamined. We aimed to assess the mechanisms linking certification as a Health Care Home (HCH), a statewide PCMH initiative, with asthma care quality and outcomes. We compared direct certification effects versus indirect clinical effects (via improved care process)...
March 1, 2018: American Journal of Managed Care
Kana R Jat, Dinesh K Walia, Anju Khairwa
BACKGROUND: Cystic fibrosis is an autosomal recessive multisystem disorder with an approximate prevalence of 1 in 3500 live births. Allergic bronchopulmonary aspergillosis is a lung disease caused by aspergillus-induced hypersensitivity with a prevalence of 2% to 15% in people with cystic fibrosis. The mainstay of treatment includes corticosteroids and itraconazole. The treatment with corticosteroids for prolonged periods of time, or repeatedly for exacerbations of allergic bronchopulmonary aspergillosis, may lead to many adverse effects...
March 18, 2018: Cochrane Database of Systematic Reviews
Jung Won Yoon, Youn Ho Sheen, Eun Kyo Ha, Ji Hyun Baek, Hey Sung Baek, Sun Hee Choi, Man Yong Han
BACKGROUND: Small airway hyperresponsiveness is a critical aspect in preschool children with asthmatic symptoms interms of asthma control. The aim of this study was to elucidate the relationship of changes in reactance (Xrs) and resistance (Rrs) of IOS and FEV1 with those in clinical parameters and to determine which IOS parameter is correlated with bronchial hyperresponsiveness before positive clinical endpoints. METHODS: We performed the methacholine challenge test in ninety-four preschool children (4...
March 12, 2018: Asian Pacific Journal of Allergy and Immunology
Karina Jahnz-Różyk, Joanna Lis, Marta Warchoł, Aleksandra Kucharczyk
BACKGROUND: Allergic asthma is the most prevalent phenotype of severe asthma where treatment with omalizumab (OMB) has been proven to be particularly beneficial. In Poland, OMB therapy is available and reimbursed within a drug programme where strict inclusion and exclusion criteria are defined. The objective of this study was to present a descriptive analysis regarding the trends in outcomes (clinical, quality of life, costs) among a cohort of patients who satisfy inclusion criteria for the initiation of OMB treatment and who successfully responded to OMB according to a set of objective criteria...
March 16, 2018: BMC Pulmonary Medicine
Atqah AbdulWahab, Aseel Zeidan, Tony Avades, Prem Chandra, Ashraf Soliman
Asthma is one of the most common chronic disorders among children. Zinc (Zn) is an essential dietary antioxidant and may have a special role in assisting the airways of asthmatic subjects. The primary objective of this study was to measure serum Zn levels among asthmatic school children and to compare this to the serum Zn level in non-asthmatic children. The secondary objective was to investigate the relationship between Zn levels and the degree of asthma control. A cross-sectional study following forty asthmatic children and forty matched non-asthmatic children of both genders was conducted...
March 16, 2018: Children
Sean A McGhee
PURPOSE OF REVIEW: Although biologic therapies can provide outstanding efficacy in the management of lung disease, especially asthma, most of these agents have been approved only for adults. Recent findings provide new strategies for using these agents in children. RECENT FINDINGS: Extensive evidence has consistently demonstrated the efficacy and safety of biologic therapy for asthma. In addition, some studies have documented potentially important secondary effects, such as improving response to respiratory virus infection in asthmatic patients...
March 13, 2018: Current Opinion in Pediatrics
Hulya Sahin, Ilknur Naz
OBJECTIVE: Pulmonary rehabilitation (PR) is an important therapeutic approach in asthmatic patients. Lack of asthma control is associated with high morbidity, poor health outcomes, and decrease in quality of life (QOL). However, there is no clear information about the effectiveness of PR in patients with differing levels of asthma control. This study aimed to compare the efficacy of PR in patients with uncontrolled and partially controlled asthma. METHODS: Before undergoing an 8-week outpatient PR program, patients were classified according to the asthma control test (ACT) as having partially controlled asthma or uncontrolled asthma...
March 13, 2018: Journal of Asthma: Official Journal of the Association for the Care of Asthma
Barbara P Yawn, Peter C Wollan, Matthew A Rank, Susan L Bertram, Young Juhn, Wilson Pace
PURPOSE: The purpose of this study was to assess patient and practice outcomes after introducing the Asthma APGAR (Activities, Persistent, triGGers, Asthma medications, Response to therapy) tools into primary care practices. METHODS: We used a pragmatic cluster-randomized controlled design in 18 US family medicine and pediatric practices to compare outcomes in patients with persistent asthma aged 5 to 45 years after introduction of the Asthma APGAR tools vs usual care...
March 2018: Annals of Family Medicine
P Veylon, M Rochoy, S Gautier, B Wallaert, C Berkhout
INTRODUCTION: Asthma is a potentially serious chronic respiratory disease impacting patients quality of life. Satisfactory control requires proper use of inhaled devices. This study assesses general medical residents and pharmacy students knowledge about proper use of inhaled asthma devices. MATERIALS AND METHODS: We evaluated knowledge of 43 general practice students and 43 pharmacy students in Lille for three inhaler devices (metered-dose inhaler, Turbuhaler® and Diskus® ) during individual interviews...
March 9, 2018: Revue de Pneumologie Clinique
Gregory E Miller, Edith Chen, Madeleine U Shalowitz, Rachel E Story, Adam K K Leigh, Paula Ham, Jesusa M G Arevalo, Steve W Cole
AIM: There are marked socioeconomic disparities in pediatric asthma control, but the molecular origins of these disparities are not well understood. To fill this gap, we performed genome-wide expression profiling of monocytes and T-helper cells from pediatric asthma patients of lower and higher socioeconomic status (SES). METHOD: Ninety-nine children with asthma participated in a cross-sectional assessment. Out of which 87% were atopic, and most had disease of mild (54%) or moderate (29%) severity...
March 12, 2018: Pediatric Pulmonology
Yo Seino, Takashi Hasegawa, Toshiyuki Koya, Takuro Sakagami, Ichiro Mashima, Natsue Shimizu, Yoshiyuki Muramatsu, Kumiko Muramatsu, Eiichi Suzuki, Toshiaki Kikuchi
Objective Whether or not depression affects the control or severity of asthma is unclear. We performed a cluster analysis of asthma patients with depressive symptoms to clarify their characteristics. Methods and subjects Multiple medical institutions in Niigata Prefecture, Japan, were surveyed in 2014. We recorded the age, disease duration, body mass index (BMI), medications, and surveyed asthma control status and severity, as well as depressive symptoms and adherence to treatment using questionnaires. A hierarchical cluster analysis was performed on the group of patients assessed as having depression...
March 9, 2018: Internal Medicine
Lucy Chambers, Joanne Finch, Karen Edwards, Antoine Jeanjean, Roland Leigh, Sherif Gonem
BACKGROUND: There is evidence that air pollution increases the risk of asthma hospitalisations and healthcare utilisation, but the effects on day-to-day asthma control are not fully understood. OBJECTIVE: We undertook a prospective single-centre panel study to test the hypothesis that personal air pollution exposure is associated with asthma symptoms, lung function and airway inflammation. METHODS: Thirty-two patients with a clinical diagnosis of asthma were provided with a personal air pollution monitor (Cairclip NO2 /O3 ) which was kept on or around their person throughout the 12-week follow-up period...
March 11, 2018: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
Umakanth Katwa, Estefania Rivera
Asthma is the most common chronic pediatric condition. Effective asthma management requires a proactive and inclusive approach that controls the patient's symptoms and prevents recurrence of exacerbations. Clinicians should encourage patients to become involved in their management since self-management approaches have proven to be an effective means for chronic illness treatment. Novel forms of self-monitoring and management are technological interventions. In the last decade, novel technology has been developed and used to improve asthma control since it is a powerful agent that addresses a variety of challenges in chronic disease management such as education, communication and adherence...
March 10, 2018: Indian Journal of Pediatrics
Vinh Nhu Nguyen, Thuong Thi Hoai Huynh, Niels H Chavannes
Background: Most asthma patients in Vietnam have poorly controlled asthma. Besides reasons related to the health care system and health care providers, knowledge on the self-management of patients has also contributed to this situation. Purpose: To assess knowledge on asthma self-management among adult asthma patients in Ho Chi Minh City. Patients and methods: A cross-sectional study with convenience sampling was conducted among 322 ambulatory patients using questionnaires filled in via a face-to-face interview...
2018: International Journal of General Medicine
Joy Lee, Tunn Ren Tay, Naghmeh Radhakrishna, Fiona Hore-Lacy, Anna Mackay, Ryan Hoy, Eli Dabscheck, Robyn O'Hehir, Mark Hew
Non-adherence to inhaled preventers impairs asthma control. Electronic monitoring devices (EMD) can objectively measure adherence. Their use has not been reported in difficult asthma patients potentially suitable for novel therapies, i.e. biologics and bronchial thermoplasty.Consecutive patients with difficult asthma were assessed for eligibility for novel therapies. Medication adherence, defined as taking 75% or more of prescribed doses, was assessed by EMD and compared to standardised clinician assessment over an eight week period...
March 8, 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
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