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Romero-Mesones C, Cruz MJ, Alobid I, Barroso B, Arismendi E, Barranco P, Betancor D, Bobolea I, Cárdaba B, Curto E, Domenech G, Domínguez-Ortega J, Espejo D, González-Barcala FJ, Luna-Porta JA, Martínez-Rivera C, Méndez-Brea P, Mullol J, Olaguibel JM, Picado C, Plaza V, Del Pozo V, Quirce S, Rial MJ, Rodrigo-Muñoz JM, Sastre J, Serrano S, Soto-Retes L, Valero A, Valverde-Monge M, Munoz X. Disposition of Work-Related Asthma in a Spanish Asthma Cohort: Comparison of Asthma Severity Between Employed and Retired Workers. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:3407-3413.e1. [PMID: 37391017 DOI: 10.1016/j.jaip.2023.06.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 06/14/2023] [Accepted: 06/15/2023] [Indexed: 07/02/2023]
Abstract
BACKGROUND Exposure to certain agents in the workplace can trigger occupational asthma or work-exacerbated asthma, both of which come under the heading of work-related asthma (WRA). Understanding the burden that WRA represents can help in the management of these patients. OBJECTIVE To assess the influence of occupation on asthma in real life and analyze the characteristics of patients with WRA included in an asthma cohort. METHODS This was a prospective multicenter study of a cohort of consecutive patients with asthma. A standardized clinical history was completed. Patients were classified as having WRA or non-WRA. All patients underwent respiratory function tests, FeNO test, and methacholine challenge (methacholine concentration that causes a 20% drop in FEV1) at the beginning of the study. They were classified into two groups, depending on their employment status: employed (group 1) or unemployed (group 2). RESULTS Of the 480 patients included in the cohort, 82 (17%) received the diagnosis of WRA. Fifty-seven patients (70%) were still working. Mean age (SD) was 46 (10.69) years in group 1 and 57 (9.91) years in group 2 (P < .0001). Significant differences were observed in adherence to treatment (64.9% in group 1 vs 88% in group 2; P = .0354) and in severe asthma exacerbations (35.7% in group 1 vs 0% in group 2; P = .0172). No significant differences were observed in the rest of the variables analyzed. CONCLUSIONS The burden of WRA in specialized asthma units is not negligible. The absence of differences in the severity of asthma, the treatment administered, alterations in lung function, and the number of exacerbations in those working versus not working may support the idea that advice regarding changing jobs should be customized for individual patients.
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Affiliation(s)
- Christian Romero-Mesones
- Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain; CIBER de Enfermedades Respiratorias, Madrid, Spain
| | - Maria-Jesus Cruz
- Servicio de Neumología. Hospital Universitario Vall d'Hebron, Barcelona, Spain; Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain; CIBER de Enfermedades Respiratorias, Madrid, Spain.
| | - Isam Alobid
- CIBER de Enfermedades Respiratorias, Madrid, Spain; Rhinology Unit and Smell Clinic, ENT Department, Hospital Clinic Barcelona, Universitat de Barcelona, Barcelona, Spain; Clinical and Experimental Respiratory Immunoallergy, Instituto de Investigaciones Biomédicas August Pi i Sunyer, Barcelona, Spain
| | - Blanca Barroso
- CIBER de Enfermedades Respiratorias, Madrid, Spain; Allergy Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Ebymar Arismendi
- CIBER de Enfermedades Respiratorias, Madrid, Spain; Allergy Unit and Severe Asthma Unit, Pneumonology and Allergy Department, Hospital Clínic, Instituto de Investigaciones Biomédicas August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain
| | - Pilar Barranco
- CIBER de Enfermedades Respiratorias, Madrid, Spain; Department of Allergy, La Paz University Hospital, IdiPAZ, Madrid, Spain
| | - Diana Betancor
- CIBER de Enfermedades Respiratorias, Madrid, Spain; Allergy Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Irina Bobolea
- CIBER de Enfermedades Respiratorias, Madrid, Spain; Allergy Unit and Severe Asthma Unit, Pneumonology and Allergy Department, Hospital Clínic, Instituto de Investigaciones Biomédicas August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain
| | - Blanca Cárdaba
- CIBER de Enfermedades Respiratorias, Madrid, Spain; Immunology Department, Instituto de Investigación Sanitaria Fundación Jiménez Díaz-Universidad Autónoma de Madrid, Madrid, Spain
| | - Elena Curto
- CIBER de Enfermedades Respiratorias, Madrid, Spain
| | - Gemma Domenech
- Medical Statistics Core Facility, Instituto de Investigaciones Biomédicas August Pi i Sunyer, Hospital Clinic Barcelona, Barcelona, Spain
| | - Javier Domínguez-Ortega
- CIBER de Enfermedades Respiratorias, Madrid, Spain; Department of Allergy, La Paz University Hospital, IdiPAZ, Madrid, Spain
| | - David Espejo
- Servicio de Neumología. Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | | | - Juan-Alberto Luna-Porta
- CIBER de Enfermedades Respiratorias, Madrid, Spain; Department of Allergy, La Paz University Hospital, IdiPAZ, Madrid, Spain
| | - Carlos Martínez-Rivera
- CIBER de Enfermedades Respiratorias, Madrid, Spain; Pulmonology Department, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona Badalona, Barcelona, Spain
| | - Paula Méndez-Brea
- Allergy Department, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, A Coruña, Spain
| | - Joaquim Mullol
- CIBER de Enfermedades Respiratorias, Madrid, Spain; Rhinology Unit and Smell Clinic, ENT Department, Clinical and Experimental Respiratory Immunoallergy (Instituto de Investigaciones Biomédicas August Pi i Sunyer), Universitat de Barcelona, Barcelona, Spain
| | | | - Cesar Picado
- Rhinology Unit and Smell Clinic, ENT Department, Hospital Clinic Barcelona, Universitat de Barcelona, Barcelona, Spain; Clinical and Experimental Respiratory Immunoallergy, Instituto de Investigaciones Biomédicas August Pi i Sunyer, Barcelona, Spain
| | - Vicente Plaza
- Servicio de Neumología y Alergia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Victoria Del Pozo
- CIBER de Enfermedades Respiratorias, Madrid, Spain; Immunology Department, Instituto de Investigación Sanitaria Fundación Jiménez Díaz-Universidad Autónoma de Madrid, Madrid, Spain
| | - Santiago Quirce
- CIBER de Enfermedades Respiratorias, Madrid, Spain; Department of Allergy, La Paz University Hospital, IdiPAZ, Madrid, Spain
| | - Manuel-Jorge Rial
- Allergy Department, Complexo Hospitalario Universitario, A Coruña, Spain
| | - José-María Rodrigo-Muñoz
- CIBER de Enfermedades Respiratorias, Madrid, Spain; Immunology Department, Instituto de Investigación Sanitaria Fundación Jiménez Díaz-Universidad Autónoma de Madrid, Madrid, Spain
| | - Joaquin Sastre
- CIBER de Enfermedades Respiratorias, Madrid, Spain; Allergy Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Sandra Serrano
- Medical Statistics Core Facility, Instituto de Investigaciones Biomédicas August Pi i Sunyer, Hospital Clinic Barcelona, Barcelona, Spain
| | - Lorena Soto-Retes
- Servicio de Neumología y Alergia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Antonio Valero
- CIBER de Enfermedades Respiratorias, Madrid, Spain; Allergy Unit and Severe Asthma Unit, Pneumonology and Allergy Department, Hospital Clínic, Instituto de Investigaciones Biomédicas August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain
| | - Marcela Valverde-Monge
- CIBER de Enfermedades Respiratorias, Madrid, Spain; Allergy Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Xavier Munoz
- Servicio de Neumología. Hospital Universitario Vall d'Hebron, Barcelona, Spain; Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain; CIBER de Enfermedades Respiratorias, Madrid, Spain
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Lam SSW, Chen J, Wu JT, Lee CF, Ragavendran N, Ong MEH, Tan NC, Loo CM, Matchar DB, Koh MS. Association of quality-of-care indicators with asthma outcomes: A retrospective observational study for asthma care in Singapore. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2023; 52:497-509. [PMID: 38920201 DOI: 10.47102/annals-acadmedsg.2023151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
Introduction Asthma guidelines have advocated for the use of quality-of-care indicators (QCIs) in asthma management. To improve asthma care, it is important to identify effective QCIs that are actionable. This study aimed to evaluate the effect of the presence of 3 QCIs: asthma education, Asthma Control Test (ACT) and spirometry testing on the time to severe exacerbation (TTSE). Method Data collected from the SingHealth COPD and Asthma Data Mart (SCDM), including asthma patients managed in 9 SingHealth polyclinics and Singapore General Hospital from January 2015 to December 2020, were analysed. Patients receiving Global Initiative for Asthma (GINA) Steps 3-5 treatment, with at least 1 QCI recorded, and at least 1 severe exacerbation within 1 year before the first QCI record, were included. Data were analysed using multivariate Cox regression and quasi-Poisson regression models. Results A total of 3849 patients in the registry fulfilled the criteria. Patients with records of asthma education or ACT assessment have a lower adjusted hazard ratio (HR) for TTSE (adjusted HR=0.88, P=0.023; adjusted HR=0.83, P<0.001). Adjusted HR associated with spirometry is higher (adjusted HR=1.22, P=0.026). No QCI was significantly associated with emergency department (ED)/inpatient visits. Only asthma education and ACT showed a decrease in the number of exacerbations for multivariate analysis (asthma education estimate: -0.181, P<0.001; ACT estimate: -0.169, P<0.001). No QCI was significant for the number of exacerbations associated with ED/inpatient visits. Conclusion Our study suggests that the perfor-mance of asthma education and ACT was associated with increased TTSE and decreased number of exacerbations, underscoring the importance of ensuring quality care in clinical practice.
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Affiliation(s)
- Sean Shao Wei Lam
- Duke-NUS Medical School, National University of Singapore, Singapore
- Health Services and Systems Research, Duke-NUS Medical School, Singapore
- Health Services Research Centre, Singapore Health Services, Singapore
- Health Services Research Institute, SingHealth Duke-NUS Academic Medical Centre, Singapore
- Lee Kong Chian School of Business, Singapore Management University, Singapore
| | - Jingwei Chen
- Duke-NUS Medical School, National University of Singapore, Singapore
| | - Jun Tian Wu
- Duke-NUS Medical School, National University of Singapore, Singapore
- Health Services and Systems Research, Duke-NUS Medical School, Singapore
- Health Services Research Centre, Singapore Health Services, Singapore
- Health Services Research Institute, SingHealth Duke-NUS Academic Medical Centre, Singapore
| | - Chun Fan Lee
- Duke-NUS Medical School, National University of Singapore, Singapore
| | - Narayanan Ragavendran
- Duke-NUS Medical School, National University of Singapore, Singapore
- Health Services and Systems Research, Duke-NUS Medical School, Singapore
- Health Services Research Centre, Singapore Health Services, Singapore
- Health Services Research Institute, SingHealth Duke-NUS Academic Medical Centre, Singapore
| | - Marcus Eng Hock Ong
- Duke-NUS Medical School, National University of Singapore, Singapore
- Health Services and Systems Research, Duke-NUS Medical School, Singapore
- Health Services Research Centre, Singapore Health Services, Singapore
- Health Services Research Institute, SingHealth Duke-NUS Academic Medical Centre, Singapore
| | - Ngiap Chuan Tan
- Duke-NUS Medical School, National University of Singapore, Singapore
- SingHealth Polyclinics, SingHealth, Singapore
| | - Chian Min Loo
- Duke-NUS Medical School, National University of Singapore, Singapore
- Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore
| | - David Bruce Matchar
- Duke-NUS Medical School, National University of Singapore, Singapore
- Department of Internal Medicine (General Internal Medicine), Duke University Medical School, Durham, North Carolina, US
| | - Mariko Siyue Koh
- Duke-NUS Medical School, National University of Singapore, Singapore
- Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore
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Volpato E, Banfi P, Pagnini F. The Interaction Between Asthma, Emotions, and Expectations in the Time of COVID-19. J Asthma Allergy 2023; 16:1157-1175. [PMID: 37881179 PMCID: PMC10596046 DOI: 10.2147/jaa.s418840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 10/13/2023] [Indexed: 10/27/2023] Open
Abstract
Introduction The main aim was to gain insight into the experience of adult people with a diagnosis of at least 6-months of mild or moderate persistent asthma according to the Global Initiative for Asthma (GINA), and their emotions, beliefs, and expectations during the first wave of COVID-19. Methods Qualitative semi-structured interviews using the Interpretative Phenomenological Analysis (IPA) were carried out by phone involving 31 people (mean age=58.2; SD=16.2). Interviews were audio recording, transcribed verbatim and analysed through thematic analysis. Results Five superordinate themes and themes were dedicated to illness (symptoms of asthma; difficulties related to COVID-19), experienced emotions (lockdown period; medical changes; emotions COVID-19 related), beliefs (about asthma; about COVID-19), expectations (related to asthma; related to COVID-19) and behaviours (to protect; risk taken; adherence; contacts with General Practitioners; support). The prevalence of emotions such as fear, worry and anxiety emerged in the participants' narratives. All are accompanied by a preference for action and problem solving. A sense of protection, connection to self and other, and commitment to life were revealed as central concepts for enhancing well-being even at a time of deterring. Discussion The common threads of the presence of uncertainty and vulnerability open the outlook of a treatment that ensures greater continuity and ownership of care in the patient, preserving the sense of self-efficacy even in times of greater instability.
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Affiliation(s)
- Eleonora Volpato
- Department of Psychology, Universita’ Cattolica del Sacro Cuore, Milan, Italy
- IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Paolo Banfi
- IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Francesco Pagnini
- Department of Psychology, Universita’ Cattolica del Sacro Cuore, Milan, Italy
- Department of Psychology, Harvard University, Cambridge, MA, USA
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Sousa-Pinto B, Louis R, Anto JM, Amaral R, Sá-Sousa A, Czarlewski W, Brussino L, Canonica GW, Chaves Loureiro C, Cruz AA, Gemicioglu B, Haahtela T, Kupczyk M, Kvedariene V, Larenas-Linnemann DE, Okamoto Y, Ollert M, Pfaar O, Pham-Thi N, Puggioni F, Regateiro FS, Romantowski J, Sastre J, Scichilone N, Taborda-Barata L, Ventura MT, Agache I, Bedbrook A, Becker S, Bergmann KC, Bosnic-Anticevich S, Bonini M, Boulet LP, Brusselle G, Buhl R, Cecchi L, Charpin D, de Blay F, Del Giacco S, Ivancevich JC, Jutel M, Klimek L, Kraxner H, Kuna P, Laune D, Makela M, Morais-Almeida M, Nadif R, Niedoszytko M, Papadopoulos NG, Papi A, Patella V, Pétré B, Rivero Yeverino D, Robalo Cordeiro C, Roche N, Rouadi PW, Samolinski B, Savouré M, Shamji MH, Sheikh A, Suppli Ulrik C, Usmani OS, Valiulis A, Yorgancioglu A, Zuberbier T, Fonseca JA, Costa EM, Bousquet J. Adherence to inhaled corticosteroids and long-acting β2-agonists in asthma: A MASK-air study. Pulmonology 2023:S2531-0437(23)00130-7. [PMID: 37543524 DOI: 10.1016/j.pulmoe.2023.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/13/2023] [Accepted: 07/15/2023] [Indexed: 08/07/2023] Open
Abstract
INTRODUCTION Adherence to controller medication is a major problem in asthma management, being difficult to assess and tackle. mHealth apps can be used to assess adherence. We aimed to assess the adherence to inhaled corticosteroids+long-acting β2-agonists (ICS+LABA) in users of the MASK-air® app, comparing the adherence to ICS+formoterol (ICS+F) with that to ICS+other LABA. MATERIALS AND METHODS We analysed complete weeks of MASK-air® data (2015-2022; 27 countries) from patients with self-reported asthma and ICS+LABA use. We compared patients reporting ICS+F versus ICS+other LABA on adherence levels, symptoms and symptom-medication scores. We built regression models to assess whether adherence to ICS+LABA was associated with asthma control or short-acting beta-agonist (SABA) use. Sensitivity analyses were performed considering the weeks with no more than one missing day. RESULTS In 2598 ICS+LABA users, 621 (23.9%) reported 4824 complete weeks and 866 (33.3%) reported weeks with at most one missing day. Higher adherence (use of medication ≥80% of weekly days) was observed for ICS+other LABA (75.1%) when compared to ICS+F (59.3%), despite both groups displaying similar asthma control and work productivity. The ICS+other LABA group was associated with more days of SABA use than the ICS+F group (median=71.4% versus 57.1% days). Each additional weekly day of ICS+F use was associated with a 4.1% less risk in weekly SABA use (95%CI=-6.5;-1.6%;p=0.001). For ICS+other LABA, the percentage was 8.2 (95%CI=-11.6;-5.0%;p<0.001). CONCLUSIONS In asthma patients adherent to the MASK-air app, adherence to ICS+LABA was high. ICS+F users reported lower adherence but also a lower SABA use and a similar level of control.
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Affiliation(s)
- B Sousa-Pinto
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences; Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS@RISE - Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
| | - R Louis
- Department of Pulmonary Medicine, CHU Liège, Liège, Belgium; GIGA I3 Research Group, University of Liège, Liège, Belgium
| | - J M Anto
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - R Amaral
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences; Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS@RISE - Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
| | - A Sá-Sousa
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences; Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS@RISE - Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
| | - W Czarlewski
- Medical Consulting Czarlewski, Levallois, France; MASK-air, Montpellier, France
| | - L Brussino
- Department of Medical Sciences, University of Torino, Torino, Italy; Allergy and Clinical Immunology Unit, Mauriziano Hospital, Torino, Italy
| | - G W Canonica
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Center, Rozzano, Milan, Italy
| | - C Chaves Loureiro
- Department of Pneumology, University of Coimbra, Medicine Faculty, Coimbra, Portugal
| | - A A Cruz
- Fundaçao ProAR, Federal University of Bahia and GARD/WHO Planning Group, Salvador, Bahia, Brazil
| | - B Gemicioglu
- Department of Pulmonary Diseases, Istanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Istanbul, Turkey
| | - T Haahtela
- Skin and Allergy Hospital, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland
| | - M Kupczyk
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | - V Kvedariene
- Institute of Clinical Medicine, Clinic of Chest Diseases and Allergology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania; Institute of Biomedical Sciences, Department of Pathology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - D E Larenas-Linnemann
- Center of Excellence in Asthma and Allergy, Médica Sur Clinical Foundation and Hospital, México City, Mexico
| | - Y Okamoto
- Chiba Rosai Hospital, Chiba, Japan; Chiba University Hospital, Chiba, Japan
| | - M Ollert
- Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg; Odense Research Center for Anaphylaxis (ORCA), and Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark
| | - O Pfaar
- Section of Rhinology and Allergy, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany
| | - N Pham-Thi
- Ecole Polytechnique de Palaiseau, Palaiseau, France; IRBA (Institut de Recherche Bio-Médicale des Armées), Brétigny sur Orge, France; Université Paris Cité, Paris, France
| | - F Puggioni
- IRCCS Humanitas Research Center, Personalized Medicine Asthma & Allergy, Rozzano, Milan, Italy
| | - F S Regateiro
- Allergy and Clinical Immunology Unit, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Center for Innovative Biomedicine and Biotechnology (CIBB), Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Institute of Immunology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - J Romantowski
- Medical University of Gdańsk, Department of Allergology, Gdansk, Poland
| | - J Sastre
- Allergy Service, Fundacion Jimenez Diaz, Autonoma University of Madrid, CIBERES-ISCIII, Madrid, Spain
| | - N Scichilone
- PROMISE Department, University of Palermo, Palermo, Italy
| | - L Taborda-Barata
- Department of Immunoallergology, Cova da Beira University Hospital Centre, Covilhã, Portugal; UBIAir - Clinical & Experimental Lung Centre and CICS-UBI Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
| | - M T Ventura
- Allergy and Clinical Immunology, University of Bari Medical School, Bari, Italy; Institute of Sciences of Food Production, National Research Council (ISPA-CNR), Bari, Italy
| | - I Agache
- Faculty of Medicine, Transylvania University of Brasov, Brasov, Romania
| | - A Bedbrook
- MASK-air, Montpellier, France; ARIA, Montpellier, France
| | - S Becker
- Department of Otorhinolaryngology, University of Tübingen, Tübingen, Germany
| | - K C Bergmann
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
| | - S Bosnic-Anticevich
- Quality Use of Respiratory Medicines Group, Woolcock Institute of Medical Research, Sydney, NSW, Australia; Macquarie Medical School, Macquarie University, Macquarie Park, NSW, Australia
| | - M Bonini
- Department of Cardiovascular and Respiratory Sciences, Universita Cattolica del Sacro Cuore, Rome, Italy; Department of Neurological, ENT and Thoracic Sciences, Fondazione Policlinico Universitario A Gemelli - IRCCS, Rome, Italy; National Heart and Lung Institute (NHLI), Imperial College London, London, UK
| | - L-P Boulet
- Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - G Brusselle
- Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - R Buhl
- Department of Pulmonary Medicine, Mainz University Hospital, Mainz, Germany
| | - L Cecchi
- SOS Allergology and Clinical Immunology, USL Toscana Centro, Prato, Italy
| | - D Charpin
- Clinique des Bronches, Allergie et Sommeil, Hôpital Nord, Marseille, France
| | - F de Blay
- Allergy Division, Chest Disease Department, University Hospital of Strasbourg, Strasbourg, France; Federation of Translational Medicine, University of Strasbourg, Strasbourg, France
| | - S Del Giacco
- Department of Medical Sciences and Public Health and Unit of Allergy and Clinical Immunology, University Hospital "Duilio Casula", University of Cagliari, Cagliari, Italy
| | - J C Ivancevich
- Servicio de Alergia e Immunologia, Clinica Santa Isabel, Buenos Aires, Argentina
| | - M Jutel
- Department of Clinical Immunology, Wrocław Medical University, Wroclaw, Poland; ALL-MED Medical Research Institute, Wroclaw, Poland
| | - L Klimek
- Department of Otolaryngology, Head and Neck Surgery, Universitätsmedizin Mainz, Mainz, Germany; Center for Rhinology and Allergology, Wiesbaden, Germany
| | - H Kraxner
- Department of Otorhinolaryngology, Head and Neck Surgery, Semmelweis University, Budapest, Hungary
| | - P Kuna
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | - D Laune
- KYomed INNOV, Montpellier, France
| | - M Makela
- Skin and Allergy Hospital, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland
| | | | - R Nadif
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Villejuif, France; Inserm, Equipe d'Epidémiologie Respiratoire Intégrative, CESP, Villejuif, France
| | - M Niedoszytko
- Department of Allergology, Medical University of Gdańsk, Gdansk, Poland
| | - N G Papadopoulos
- Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece
| | - A Papi
- Respiratory Medicine, Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - V Patella
- Division of Allergy and Clinical Immunology, Department of Medicine, "Santa Maria della Speranza" Hospital, Battipaglia, Salerno, Italy; Agency of Health ASL, Salerno, Italy; Postgraduate Programme in Allergy and Clinical Immunology, University of Naples Federico II, Naples, Italy
| | - B Pétré
- Department of Public Health, University of Liège, Liège, Belgium
| | - D Rivero Yeverino
- Servicio de Alergia e Inmunología clínica, Hospital Universitario de Puebla, Puebla, México
| | - C Robalo Cordeiro
- Department of Pneumology, University of Coimbra, Medicine Faculty, Coimbra, Portugal
| | - N Roche
- Pneumologie, AP-HP Centre Université de Paris Cité, Hôpital Cochin, Paris, France; UMR 1016, Institut Cochin, Paris, France
| | - P W Rouadi
- Department of Otolaryngology-Head and Neck Surgery, Eye and Ear University Hospital, Beirut, Lebanon; Department of Otorhinolaryngology-Head and Neck Surgery, Dar Al Shifa Hospital, Salmiya, Kuwait
| | - B Samolinski
- Department of Prevention of Environmental Hazards, Allergology and Immunology, Medical University of Warsaw, Warsaw, Poland
| | - M Savouré
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Villejuif, France; Inserm, Equipe d'Epidémiologie Respiratoire Intégrative, CESP, Villejuif, France
| | - M H Shamji
- National Heart and Lung Institute (NHLI), Imperial College London, London, UK; NIHR Imperial Biomedical Research Centre, London, UK
| | - A Sheikh
- Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - C Suppli Ulrik
- Department of Respiratory Medicine, Copenhagen University Hospital-Hvidovre, Copenhagen, Denmark; Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - O S Usmani
- National Heart and Lung Institute (NHLI), Imperial College London, London, UK; Royal Brompton Hospital, Airways Disease Section, London, UK
| | - A Valiulis
- Interdisciplinary Research Group of Human Ecology, Institute of Clinical Medicine and Institute of Health Sciences, Medical Faculty of Vilnius University, Vilnius, Lithuania; European Academy of Paediatrics (EAP/UEMS-SP), Brussel, Belgium
| | - A Yorgancioglu
- Department of Pulmonary Diseases, Celal Bayar University, Faculty of Medicine, Manisa, Turkey
| | - T Zuberbier
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
| | - J A Fonseca
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences; Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS@RISE - Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
| | - E M Costa
- UCIBIO, REQUINTE, Faculty of Pharmacy and Competence Center on Active and Healthy Ageing of University of Porto (Porto4Ageing), Porto, Portugal
| | - J Bousquet
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany; Inserm, Equipe d'Epidémiologie Respiratoire Intégrative, CESP, Villejuif, France; University Hospital Montpellier, Montpellier, France.
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5
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Abtahi H, Amini S, Gholamzadeh M, Gharabaghi MA. Development and evaluation of a mobile-based asthma clinical decision support system to enhance evidence-based patient management in primary care. INFORMATICS IN MEDICINE UNLOCKED 2023. [DOI: 10.1016/j.imu.2023.101168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
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6
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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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7
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ZHENG HZ, QIU Q, XIONG J, CHEN J, GUAN LC. Moxibustion pretreatment inhibits RhoA/ROCK signaling to prevent lung inflammation in asthmatic rats 艾灸预处理降低RhoA/ROCK信号表达预防哮喘大鼠肺炎. WORLD JOURNAL OF ACUPUNCTURE-MOXIBUSTION 2022. [DOI: 10.1016/j.wjam.2022.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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8
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Guo Z, Zheng L, Fu M, Li H, Bai L, Guan X, Shi L. Effects of the Full Coverage Policy of Essential Medicines on Inequality in Medication Adherence: A Longitudinal Study in Taizhou, China. Front Pharmacol 2022; 13:802219. [PMID: 35185563 PMCID: PMC8850774 DOI: 10.3389/fphar.2022.802219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 01/13/2022] [Indexed: 11/13/2022] Open
Abstract
The full coverage policy for essential medicines (FCPEMs) was proposed and implemented in Taizhou city of Zhejiang Province, China, to promote equal access and adherence to medicines. This study aimed to examine the effects of FCPEMs on the income-related inequality in medication adherence among local patients with hypertension or diabetes. We collected electronic health records of patients with hypertension or diabetes of three districts of Taizhou from 2011 to 2016. As the implementation schedule of the FCPEMs varied across districts, we applied a retrospective longitudinal study design and assigned records from 1 year before to 3 years following the implementation of FCPEMs as baseline and follow-up data. We thus generated a dataset with 4-year longitudinal data. The concentration index (CI) and its decomposition method were employed to measure factors contributing to inequality in medication adherence and the role played by FCPEMs. The sample size rose from 264,836 at the baseline to 315,677, 340,512, and 355,676 by each follow-up year, and the proportion of patients taking free medicines rose from 17.6 to 25.0 and 29.8% after FCPEMs implementation. The proportion of patients with high adherence increased from 39.9% at baseline to 51.6, 57.2, and 60.5%, while CI decreased from 0.073 to −0.011, −0.029, and −0.035. The contribution of FCPEMs ranked at 2nd/13, 7th/13, and 2nd/13 after the implementation of FCPEMs. Changes in CI of medication adherence for every 2 years were −0.084, −0.018, and −0.006, and the contribution of FCPEMs was −0.006, 0.006, and 0.007, ranking at 2nd/13, 2nd/13, and 1st/13, respectively. Most changes in CI of medication adherence can be attributed to FCPEMs. The medication adherence of patients with hypertension or diabetes improved after the implementation FCPEMs in Taizhou, although inequality did not improve consistently. In general, FCPEMs could be a protective factor against income-related inequalities in access and adherence to medicines. Future research is needed to investigate the change mechanism and the optimal design of similar interventions.
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Affiliation(s)
- Zhigang Guo
- Department of Pharmacy, Peking University School and Hospital of Stomatology, Beijing, China
- International Research Center for Medicinal Administration, Peking University, Beijing, China
| | - Liguang Zheng
- Department of Pharmacy, Peking University School and Hospital of Stomatology, Beijing, China
| | - Mengyuan Fu
- School of Pharmaceutical Sciences, Peking University, Beijing, China
| | - Huangqianyu Li
- International Research Center for Medicinal Administration, Peking University, Beijing, China
| | - Lin Bai
- School of Pharmaceutical Sciences, Peking University, Beijing, China
| | - Xiaodong Guan
- International Research Center for Medicinal Administration, Peking University, Beijing, China
- School of Pharmaceutical Sciences, Peking University, Beijing, China
- *Correspondence: Xiaodong Guan,
| | - Luwen Shi
- International Research Center for Medicinal Administration, Peking University, Beijing, China
- School of Pharmaceutical Sciences, Peking University, Beijing, China
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9
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Serhal S, Saini B, Bosnic-Anticevich S, Krass I, Emmerton L, Bereznicki B, Bereznicki L, Mitchell B, Wilson F, Wright B, Wilson K, Weier N, Segrott R, Cleveland R, Jan S, Shan S, Billot L, Armour C. A Targeted Approach to Improve Asthma Control Using Community Pharmacists. Front Pharmacol 2022; 12:798263. [PMID: 35024035 PMCID: PMC8743269 DOI: 10.3389/fphar.2021.798263] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 11/26/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Building on lessons learnt from evidence-based community pharmacy asthma management models, a streamlined and technology supported Pharmacy Asthma Service (PAS) was developed to promote the integration of the service into routine practice. Objective: This study investigates the efficacy of the PAS in improving asthma symptom control and other health outcomes. Methods: A two-arm pragmatic cluster randomized controlled trial was implemented in 95 pharmacies across three Australian States. Participants were adults with poorly controlled asthma as per the Asthma Control Questionnaire (ACQ), with or without allergic rhinitis. Patients within the PAS arm engaged in four consultations with the pharmacist over a 12-month period. An evidence-based algorithm guided pharmacies, via a trial specific software, to deliver a series of interventions targeting three issues underpinning uncontrolled asthma (medication use and adherence, inhaler technique, and allergic rhinitis management) to patient clinical asthma status and patient need. Comparator arm patients received a minimal intervention likened to usual practice involving referral of eligible patients to the GP and two follow-up consultations with their pharmacist to collect comparative data. Results: In total, 143 of 221 PAS patients (65%) and 111 of 160 comparator patients (69%) completed the trial. Improvements in asthma control were achieved in both the PAS (mean difference (MD) in ACQ from baseline = −1.10, p <.0001) and comparator (MD in ACQ from baseline = −0.94, p <.0001) arms at the trial end; however, there were no significant differences between the two arms (MD = −0.16, 95% CI −0.41 to 0.08, p = 0.19). Patients’ quality of life in the PAS arm improved significantly when compared with the comparator arm (MD in Impact of Asthma on Quality-of-Life Questionnaire (IAQLQ) = −0.52, 95% CI −0.89 to −0.14, p = 0.0079). Conclusion: Despite the PAS achieving a greater improvement in patients’ quality of life, the pharmacist-led service and usual practice arm produced comparable improvements in asthma control. These results ask us to reflect on current standards of usual care, as it appears the standard of asthma care in usual practice has evolved beyond what is reported in the literature.
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Affiliation(s)
- Sarah Serhal
- Woolcock Institute of Medical Research, Sydney, NSW, Australia.,School of Pharmacy, The University of Sydney, Sydney, NSW, Australia
| | - Bandana Saini
- Woolcock Institute of Medical Research, Sydney, NSW, Australia.,School of Pharmacy, The University of Sydney, Sydney, NSW, Australia
| | - Sinthia Bosnic-Anticevich
- Woolcock Institute of Medical Research, Sydney, NSW, Australia.,Central Sydney Area Health Service, Sydney, NSW, Australia
| | - Ines Krass
- School of Pharmacy, The University of Sydney, Sydney, NSW, Australia
| | - Lynne Emmerton
- Curtin Medical School, Curtin University, Perth, WA, Australia
| | | | - Luke Bereznicki
- School of Pharmacy and Pharmacology, University of Tasmania, Hobart, TAS, Australia
| | | | - Frances Wilson
- Woolcock Institute of Medical Research, Sydney, NSW, Australia
| | - Bronwen Wright
- Curtin Medical School, Curtin University, Perth, WA, Australia
| | - Kiara Wilson
- School of Pharmacy and Pharmacology, University of Tasmania, Hobart, TAS, Australia
| | - Naomi Weier
- The Pharmaceutical Society of Australia, Deakin, ACT, Australia
| | | | - Rhonda Cleveland
- National Asthma Council Australia, South Melbourne, VIC, Australia
| | - Stephen Jan
- The George Institute, Newtown, NSW, Australia.,Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Sana Shan
- The George Institute, Newtown, NSW, Australia
| | - Laurent Billot
- The George Institute, Newtown, NSW, Australia.,Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Carol Armour
- Woolcock Institute of Medical Research, Sydney, NSW, Australia.,Central Sydney Area Health Service, Sydney, NSW, Australia
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10
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Cunningham J, M. Briggs A, Cottrell E, Doyle F, Dziedzic K, Finney A, Murphy P, Paskins Z, Sheridan E, Swaithes L, P. French H. Barriers and facilitators to the implementation of osteoarthritis management programmes in primary or community care settings: a systematic review and qualitative framework synthesis protocol. HRB Open Res 2021; 4:102. [PMID: 34746643 PMCID: PMC8543168 DOI: 10.12688/hrbopenres.13377.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2021] [Indexed: 12/29/2022] Open
Abstract
Despite consistent international guidelines for osteoarthritis (OA) management, evidence-based treatments are underutilised. OA management programmes (OAMPs) are being implemented internationally to address this evidence-practice gap. An OAMP is defined as a 'model of evidence-based, non-surgical OA care that has been implemented in a real-world setting'. Our objective is to identify, synthesise and appraise qualitative research identifying anticipated or experienced micro (individual/behavioural), meso (organisational) or macro (context/system) level barriers or facilitators to the implementation of primary or community care-based OAMPs. Five electronic databases will be searched for papers published between 2010 and 2021. Qualitative or mixed-methods studies that include qualitative data on the anticipated or experienced barriers or facilitators to the implementation of primary or community care-based OAMPs, from the perspective of service users or service providers, will be included. The review will be reported using the PRISMA and ENTREQ guidelines. A data extraction form will be used to provide details of the included studies. Data will be analysed and identified barriers and facilitators will be mapped onto an appropriate implementation framework, such as the Theoretical Domains Framework. The appropriate JBI critical appraisal tools will be used to assess methodological quality, while the GRADE-CERQual approach will be used to assess confidence in the findings. Translation of evidence-based guidelines into practice is challenging and reliant on the quality of implementation. By comparing and contrasting anticipated and experienced barriers, this review will determine the extent of congruence between the two, and provide valuable insights into the views and experiences of key stakeholders involved in the implementation of OAMPs. The mapping of identified barriers and facilitators to behaviour change theory will enhance the applicability and construct validity of our findings and will offer significant utility for future development and implementation of OAMPs. Registration: This protocol was registered with PROSPERO (CRD42021255698) on 15/07/21.
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Affiliation(s)
- Joice Cunningham
- School of Physiotherapy, Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, Dublin, Ireland
| | - Andrew M. Briggs
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Elizabeth Cottrell
- Impact Accelerator Unit, Versus Arthritis Primary Care Centre, School of Medicine, Keele University, Staffordshire, ST5 5BG, UK
| | - Frank Doyle
- Department of Health Psychology, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | - Krysia Dziedzic
- Impact Accelerator Unit, Versus Arthritis Primary Care Centre, School of Medicine, Keele University, Staffordshire, ST5 5BG, UK
| | - Andrew Finney
- Impact Accelerator Unit, Versus Arthritis Primary Care Centre, School of Medicine, Keele University, Staffordshire, ST5 5BG, UK
| | - Paul Murphy
- RCSI Library, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Zoe Paskins
- Impact Accelerator Unit, Versus Arthritis Primary Care Centre, School of Medicine, Keele University, Staffordshire, ST5 5BG, UK
- Haywood Academic Rheumatology Centre, Midland Partnership NHS Foundation Trust, Stoke-on-Trent, ST6 7AG, UK
| | - Eoin Sheridan
- School of Physiotherapy, Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, Dublin, Ireland
| | - Laura Swaithes
- Impact Accelerator Unit, Versus Arthritis Primary Care Centre, School of Medicine, Keele University, Staffordshire, ST5 5BG, UK
| | - Helen P. French
- School of Physiotherapy, Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, Dublin, Ireland
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11
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Abstract
Since asthma is the most common noncommunicable chronic childhood disease in the United States, school nurses will encounter students with this health condition. The purpose of this article is to present the school nurse as the leader in directing the management of a student's chronic health condition at school. This article provides a table of resources and discusses many aspects of asthma management, including utilization of the student's asthma action plan, student-specific school accommodation needs, the importance of developing individualized healthcare plans, providing education to school staff related to asthma management and determining of the family and student knowledge level, as well as strategies to minimize exacerbations. The article also explores school nurse opportunity to advocate for emergency asthma medication access as a part of emergency preparedness. School-based asthma management can be complex and school nurses have a pivotal role in asthma management in a school.
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Affiliation(s)
- Anne F Russell
- Nursing Faculty, Spring Arbor University, Spring Arbor, MI
| | - Anil Nanda
- Allergist/Immunologist, Associate Clinical Professor of Medicine, Division of Allergy and Immunology, University of Texas Southwestern Medical Center, Dallas, TX.,Asthma and Allergy Center, Lewisville and Flower Mound, TX
| | - Theresa A Bingemann
- Allergist/Immunologist, Associate Professor of Pediatrics and Medicine, University of Rochester, Rochester, NY
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12
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Mendes NF, Jara CP, Mansour E, Araújo EP, Velloso LA. Asthma and COVID-19: a systematic review. Allergy Asthma Clin Immunol 2021; 17:5. [PMID: 33407838 PMCID: PMC7787409 DOI: 10.1186/s13223-020-00509-y] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 12/21/2020] [Indexed: 12/19/2022] Open
Abstract
Background Severe coronavirus disease-19 (COVID-19) presents with progressive dyspnea, which results from acute lung inflammatory edema leading to hypoxia. As with other infectious diseases that affect the respiratory tract, asthma has been cited as a potential risk factor for severe COVID-19. However, conflicting results have been published over the last few months and the putative association between these two diseases is still unproven. Methods Here, we systematically reviewed all reports on COVID-19 published since its emergence in December 2019 to June 30, 2020, looking into the description of asthma as a premorbid condition, which could indicate its potential involvement in disease progression. Results We found 372 articles describing the underlying diseases of 161,271 patients diagnosed with COVID-19. Asthma was reported as a premorbid condition in only 2623 patients accounting for 1.6% of all patients. Conclusions As the global prevalence of asthma is 4.4%, we conclude that either asthma is not a premorbid condition that contributes to the development of COVID-19 or clinicians and researchers are not accurately describing the premorbidities in COVID-19 patients.
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Affiliation(s)
- Natália F Mendes
- School of Nursing, State University of Campinas, Campinas, Brazil.,Laboratory of Cell Signaling, Obesity and Comorbidities Research Center, State University of Campinas, Rua Carl Von Lineaus s/n, Instituto de Biologia, Bloco Z. Campus Universitário Zeferino Vaz, Barão Geraldo, Campinas, SP, 13083-864, Brazil
| | - Carlos P Jara
- School of Nursing, State University of Campinas, Campinas, Brazil.,Laboratory of Cell Signaling, Obesity and Comorbidities Research Center, State University of Campinas, Rua Carl Von Lineaus s/n, Instituto de Biologia, Bloco Z. Campus Universitário Zeferino Vaz, Barão Geraldo, Campinas, SP, 13083-864, Brazil
| | - Eli Mansour
- Clinical Immunology and Allergy, Department of Internal Medicine, State University of Campinas, Campinas, Brazil
| | - Eliana P Araújo
- School of Nursing, State University of Campinas, Campinas, Brazil.,Laboratory of Cell Signaling, Obesity and Comorbidities Research Center, State University of Campinas, Rua Carl Von Lineaus s/n, Instituto de Biologia, Bloco Z. Campus Universitário Zeferino Vaz, Barão Geraldo, Campinas, SP, 13083-864, Brazil
| | - Licio A Velloso
- Laboratory of Cell Signaling, Obesity and Comorbidities Research Center, State University of Campinas, Rua Carl Von Lineaus s/n, Instituto de Biologia, Bloco Z. Campus Universitário Zeferino Vaz, Barão Geraldo, Campinas, SP, 13083-864, Brazil. .,Clinical Immunology and Allergy, Department of Internal Medicine, State University of Campinas, Campinas, Brazil.
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13
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Serhal S, Saini B, Bosnic-Anticevich S, Krass I, Wilson F, Armour C. Medication Adherence in a Community Population with Uncontrolled Asthma. PHARMACY 2020; 8:pharmacy8040183. [PMID: 33036454 PMCID: PMC7711630 DOI: 10.3390/pharmacy8040183] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/29/2020] [Accepted: 10/03/2020] [Indexed: 12/12/2022] Open
Abstract
It is well documented that the use of medications in asthma and allergic rhinitis is often suboptimal, and consequently, patients remain symptomatic. This study aimed to determine the extent and type of medication-related issues contributing to poor asthma control by profiling medication management in those most at risk—a population with clinically uncontrolled asthma. Participants (n = 363) were recruited from Australian community pharmacies, and a dispensed medication history report for the previous 12 months was collected to examine medication adherence and factors affecting adherence. Information was also collected regarding participant asthma control and asthma/allergic rhinitis (if applicable) management. The participants’ mean asthma control score was 2.49 (± 0.89 SD, IQR = 1.20) (score ≥ 1.5 indicative of poorly controlled asthma), and 72% were either non-adherent or yet to initiate preventer therapy. Almost half had been prescribed high doses of inhaled corticosteroid and 24% reported use of oral corticosteroids. Only 22% of participants with concomitant allergic rhinitis were using first line treatment. A logistic regression model highlighted that participant health care concession status and hospital admissions were associated with better adherence. Suboptimal medication management is evident in this at-risk population.
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Affiliation(s)
- Sarah Serhal
- Woolcock Institute of Medical Research, 431 Glebe Point Road, Glebe, NSW 2031, Australia; (B.S.); (S.B.-A.); (F.W.); (C.A.)
- Correspondence: ; Tel.: +61-4-1495-9883
| | - Bandana Saini
- Woolcock Institute of Medical Research, 431 Glebe Point Road, Glebe, NSW 2031, Australia; (B.S.); (S.B.-A.); (F.W.); (C.A.)
- School of Pharmacy, The University of Sydney, A15, Science Rd, Camperdown, NSW 2006, Australia;
| | - Sinthia Bosnic-Anticevich
- Woolcock Institute of Medical Research, 431 Glebe Point Road, Glebe, NSW 2031, Australia; (B.S.); (S.B.-A.); (F.W.); (C.A.)
- School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2006, Australia
| | - Ines Krass
- School of Pharmacy, The University of Sydney, A15, Science Rd, Camperdown, NSW 2006, Australia;
| | - Frances Wilson
- Woolcock Institute of Medical Research, 431 Glebe Point Road, Glebe, NSW 2031, Australia; (B.S.); (S.B.-A.); (F.W.); (C.A.)
| | - Carol Armour
- Woolcock Institute of Medical Research, 431 Glebe Point Road, Glebe, NSW 2031, Australia; (B.S.); (S.B.-A.); (F.W.); (C.A.)
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