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Norelli F, Schiappoli M, Senna G, Pinter P, Olivieri B, Ottaviano G, De Corso E, Caminati M. Adherence to Intranasal Steroids in Chronic Rhinosinusitis with Nasal Polyposis Prior to and during Biologic Therapy: A Neglected Matter. J Clin Med 2024; 13:1066. [PMID: 38398379 PMCID: PMC10889709 DOI: 10.3390/jcm13041066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/31/2024] [Accepted: 02/05/2024] [Indexed: 02/25/2024] Open
Abstract
Adherence to treatment is essential in chronic rhinosinusitis with nasal polyposis (CRSwNP). Intranasal corticosteroids (INCS) are the first-line therapy, followed by systemic corticosteroids and surgery if needed. In cases of refractory disease, biologics are added to conventional treatment, making adherence to INCS crucial in assessing eligibility for these targeted therapies. The purpose of this review is to examine INCS adherence assessment and rate, before starting and during biologic therapy. We conducted a comprehensive literature review focusing on INCS adherence in CRSwNP treated with biologics, including randomized controlled trials and real-life studies. The search extended to studies on allergic and non-allergic rhinitis to provide broader insights into tools to assess the INCS adherence. The result was that adherence to INCS in CRSwNP is underexplored, with only a few studies addressing it directly. Various tools for adherence assessment have been identified, but none are universally accepted as standard. The review also highlights the complexity of factors influencing adherence rates. Effective CRSwNP management requires a paradigm shift to prioritize adherence in treatment guidelines and clinical practice. The review advocates for improved adherence assessment tools, a deeper understanding of influencing factors, and the integration of personalized medicine approaches, especially for biologic therapies.
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Affiliation(s)
- Francesca Norelli
- Department of Medicine, University of Verona, 37129 Verona, Italy; (F.N.); (G.S.)
| | - Michele Schiappoli
- Allergy Unit and Asthma Center, Verona Integrated University Hospital, 35134 Verona, Italy; (M.S.); (B.O.)
| | - Gianenrico Senna
- Department of Medicine, University of Verona, 37129 Verona, Italy; (F.N.); (G.S.)
- Allergy Unit and Asthma Center, Verona Integrated University Hospital, 35134 Verona, Italy; (M.S.); (B.O.)
| | - Patrick Pinter
- Division of Otorhinolaryngology, Department of Surgery, Dentistry, Gynecology, and Pediatrics, Verona University Hospital, University of Verona, 37129 Verona, Italy;
| | - Bianca Olivieri
- Allergy Unit and Asthma Center, Verona Integrated University Hospital, 35134 Verona, Italy; (M.S.); (B.O.)
| | - Giancarlo Ottaviano
- Otolaryngology Section, Department of Neurosciences, University of Padova, 35122 Padova, Italy;
| | - Eugenio De Corso
- Otorhinolaryngology Unit, A. Gemelli University Hospital Foundation IRCCS, 00168 Rome, Italy;
| | - Marco Caminati
- Department of Medicine, University of Verona, 37129 Verona, Italy; (F.N.); (G.S.)
- Allergy Unit and Asthma Center, Verona Integrated University Hospital, 35134 Verona, Italy; (M.S.); (B.O.)
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Morales Viana LC, Castillo-Espitia E. Taking care of myself in a different and broken world: self-care practices of adolescents on dialysis. Int J Qual Stud Health Well-being 2023; 18:2171562. [PMID: 36722818 PMCID: PMC9897745 DOI: 10.1080/17482631.2023.2171562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
PURPOSE Being on dialysis is a traumatic situation particularly during adolescence. Therefore, adolescents must have self-care support according to their special needs. The goal of this study was to describe the adolescents´ self-care practices when they are on dialysis. This paper reports only the adolescents´ selfcare practices based on the health care team guidelines but adjusted to their beliefs and habits. METHODS The methodology of the study was interpretive phenomenology. In-depth interviews were conducted with 15 adolescents; Smith´s IPA procedure was used for data analysis. RESULTS Being on dialysis meant to the adolescents living in a different and broken world. Self-care practices included: 1) coexisting with the dialysis slavery or being attached to a machine day or night, 2) struggling with the maddening thirst experience, 3) Deciding what, when and how much food to eat, 4) taking care of an alien that helps to survive, 5) taking the medicines when feeling in need of them. CONCLUSION The adolescents tried to care for themselves adjusting their care activities to the health team´s recommendations. However, they also adjusted those practices to their beliefs and habits, which allows them to live with dialysis in a less traumatic way.
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Affiliation(s)
- Liliana Cristina Morales Viana
- Department of Pediatric Nursing, Universidad del Valle, Cali, Colombia,CONTACT Liliana Cristina Morales Viana Department of Pediatric Nursing, Universidad del Valle, Cali760032, Colombia
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Özdemir KC, Jacobsen R, Dahl M, Landt E. Factors associated with medication adherence among adults with asthma. J Asthma 2022; 60:1202-1209. [PMID: 36278848 DOI: 10.1080/02770903.2022.2139717] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE Asthma medication adherence is of crucial importance for successful disease management. The aim of this study was to identify and rank factors associated with medication adherence among adults with asthma in the general population. METHODS We used data on physician-diagnosed asthma, medication adherence, and factors associated with asthma medication adherence from the Danish General Suburban Population Study using a cross-sectional study design. We ranked factors associated with asthma medication adherence based on the magnitude of odds ratios, and the population attributable fractions. RESULTS Among 20,032 individuals from the general population, 1,128 (6%) suffered from asthma and 822 (73%) of these were adherent to asthma medications. Based on odds ratios, the three top-ranked factors associated with asthma medication adherence were asthma attacks within the past year (4.0; 95% CI: 2.9-5.5), allergy medication use (3.8; 2.6-5.6), and age above median (3.4; 2.4-4.7), followed by asthma severity markers like airway obstruction, and coughing with mucus. Based on population attributable fractions, the three top-ranked factors associated with adherence to asthma medications were asthma attacks within the past year (70%), age above median (57%), and use of allergy medication (49%). CONCLUSIONS The study showed that in the general population recent asthma attacks, higher age, and taking allergy medication were the three most important factors associated with asthma medication adherence. The importance of maintaining adherence to asthma medications even in the absence of severe disease or expressed asthma symptoms should be better communicated to the general population.
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Affiliation(s)
- Kudret C. Özdemir
- Research Group for Social and Clinical Pharmacy, Department of Pharmacy, University of Copenhagen, Faculty of Health and Medical Sciences, Copenhagen, Denmark
- Department of Clinical Biochemistry, Zealand University Hospital, Region Zealand, Denmark
| | - Ramune Jacobsen
- Research Group for Social and Clinical Pharmacy, Department of Pharmacy, University of Copenhagen, Faculty of Health and Medical Sciences, Copenhagen, Denmark
| | - Morten Dahl
- Department of Clinical Biochemistry, Zealand University Hospital, Region Zealand, Denmark
- Department of Clinical Medicine, University of Copenhagen, Faculty of Health and Medical Sciences, Copenhagen, Denmark
| | - Eskild Landt
- Department of Clinical Biochemistry, Zealand University Hospital, Region Zealand, Denmark
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Ischander M, Lozowski-Sullivan S. Psychologist's Unique Role in Improving Quality of Life of Children with Chronic Lung Diseases and Their Families. Pediatr Clin North Am 2022; 69:951-963. [PMID: 36207105 DOI: 10.1016/j.pcl.2022.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Pediatric chronic lung diseases burden their patients and families with heavy treatment loads, frequent extensive clinic visits to multiple providers, frequent emergency department visits and hospitalizations, and contribute to significant psychosocial issues with caregiver's burnout. The purpose of this chapter is to outline the psychosocial impact of the major pediatric chronic lung diseases and the unique role of the psychologist in relieving this burden. These include severe asthma, cystic fibrosis, bronchopulmonary dysplasia, and dependence on home mechanical ventilation.
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Affiliation(s)
- Mariam Ischander
- Department of Pediatric and Adolescent Medicine, Division of Pulmonology and Sleep Medicine, Western Michigan University, Homer Stryker MD School of Medicine, 1000 Oakland Drive, Kalamazoo, MI 49008, USA.
| | - Sheryl Lozowski-Sullivan
- Department of Pediatric and Adolescent Medicine, Division of Psychology, Western Michigan University, Homer Stryker MD School of Medicine, 1000 Oakland Drive, Kalamazoo, MI 49008, USA
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Molecular Mechanism of YuPingFeng in the Treatment of Asthma Based on Network Pharmacology and Molecular Docking Technology. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:7364126. [PMID: 36105239 PMCID: PMC9467798 DOI: 10.1155/2022/7364126] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 07/26/2022] [Indexed: 11/17/2022]
Abstract
Objective To explore the molecular targets and mechanism of YuPingFeng (YPF) for the treatment of asthma by using network pharmacology and molecular docking. Methods The potential active ingredients and relevant targets of YPF were obtained from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP). Asthma-related gene targets were retrieved from GeneCards, OMIM, DrugBank, PharmGKB, and TTD databases. The protein-protein (PPI) network between YPF and asthma common targets was constructed by SRING online database and Cytoscape software. GO and KEGG analyses were performed to explore the complicated molecular biological processes and potential pathways. Finally, a molecular docking approach was carried out to verify the results. Results We obtained 100 potential targets of the 35 active ingredients in YPF and 1610 asthma-related targets. 60 YPF-asthma common targets were selected to perform PPI analysis. Seven core genes were screened based on two topological calculation methods. GO and KEGG results showed that the main pathways of YPF in treating asthma include TNF signaling pathway and PI3K-Akt signaling pathway. Finally, the molecular docking results indicated that the key ingredients of YPF had a good affinity with the relevant core genes. Conclusion This study reflects the multicomponent, multitarget, and multipathway characteristics of YPF in treating asthma, providing a theoretical and scientific basis for the intervention of asthma by traditional Chinese medicine YPF.
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AlOlayan AM, Alhammad MA, Almutairi AA, Alshammari MT, Albuhairi S. Adherence to Asthma Controller Therapy Among Children in Majmaah City, Saudi Arabia. Cureus 2021; 13:e14633. [PMID: 34046270 PMCID: PMC8140659 DOI: 10.7759/cureus.14633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background and objective Improving adherence to asthma medications may prevent asthma exacerbation, which is associated with a decline in lung function. The purpose of this study was to assess the adherence to asthma controller therapy and the factors that might influence the level of adherence among asthmatic children. Materials and methods We conducted a prospective observational study at the King Khalid Hospital in Majmaah, Saudi Arabia between January and April 2020; the study was conducted among children aged 1-14 years with a diagnosis of asthma. The data collected when available included age and gender by using a pre-tested questionnaire that contained four validated items, and the respondents were the parents of the affected children. Due to the coronavirus disease 2019 (COVID-19) pandemic, the data collection was performed via phone calls to ensure safety. Informed consent was obtained from the parents. Results We analyzed 152 asthmatic children to evaluate their adherence to asthma controller therapy. The majority of the children were males (60%). Asthma was most prevalent in the age group of 6-10 years (40.1%), followed by the age group of two to five years (32.9%). We found that the majority of the patients had poor adherence to asthma medication (83.6%) while the remaining had good adherence (16.4%). The total mean score for adherence to medication therapy was 5.16 (SD: 2.3). Conclusions The present study showed that the overall adherence level to the asthma controller therapy was poor among children. Larger, nationwide studies are needed to assess the adherence to asthma medications and implement interventions that can improve the same.
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Affiliation(s)
- Abdullah M AlOlayan
- Department of Pediatrics, College of Medicine, Majmaah University, Majmaah, SAU
| | | | | | | | - Sultan Albuhairi
- Department of Pediatrics - Allergy and Immunology Section, King Faisal Specialist Hospital and Research Center, Riyadh, SAU
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Licari A, Ferrante G, Marseglia Md GL, Corsello Md G, La Grutta S. What Is the Impact of Innovative Electronic Health Interventions in Improving Treatment Adherence in Asthma? The Pediatric Perspective. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2019; 7:2574-2579. [PMID: 31425835 DOI: 10.1016/j.jaip.2019.08.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 07/26/2019] [Accepted: 08/08/2019] [Indexed: 01/25/2023]
Abstract
Suboptimal adherence to treatment is a significant issue in the management of pediatric asthma and is a major cause of uncontrolled disease, life-threatening attacks, and increased use of health care resources. Electronic health solutions have the potential to positively impact asthma self-management in children and adolescents and their families, thereby improving treatment adherence and asthma outcomes. However, there is a lack of sufficient data to support widespread adoption of electronic health tools in pediatric asthma practice. A critical evaluation of the impact of these new interventions on treatment adherence in childhood asthma must consider unmet needs, heterogeneity of trials, safety and data security issues, long-term effects, and cost-effectiveness. This article explores the most relevant issues facing the role of electronic health and its subcategory-mobile health-in promoting treatment adherence in childhood asthma, focusing on current evidence gaps and limitations, and future research perspectives.
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Affiliation(s)
- Amelia Licari
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, Pediatric Unit, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
| | - Giuliana Ferrante
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialities, University of Palermo, Palermo, Italy
| | - Gian Luigi Marseglia Md
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, Pediatric Unit, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Giovanni Corsello Md
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialities, University of Palermo, Palermo, Italy
| | - Stefania La Grutta
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialities, University of Palermo, Palermo, Italy; Institute of Biomedical Research and Innovation, Palermo, Italy
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