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Braido F, Baiardini I, Alleri P, Bacci E, Barbetta C, Bellocchia M, Benfante A, Blasi F, Bucca C, Busceti MT, Centanni S, Colanardi MC, Contoli M, Corsico A, D'Amato M, Di Marco F, Marco D, Ferrari M, Florio G, Fois AG, Foschino Barbaro MP, Silvia G, Girbino G, Grosso A, Latorre M, Maniscalco S, Mazza F, Mereu C, Molinengo G, Ora J, Paggiaro P, Patella V, Pelaia G, Pirina P, Proietto A, Rogliani P, Santus P, Scichilone N, Simioli F, Solidoro P, Terraneo S, Zuccon U, Canonica GW. Asthma management in a specialist setting: Results of an Italian Respiratory Society survey. Pulm Pharmacol Ther 2017; 44:83-87. [PMID: 28341462 DOI: 10.1016/j.pupt.2017.03.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 03/11/2017] [Accepted: 03/17/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND Asthma considerably impairs patients' quality of life and increases healthcare costs. Severity, morbidity, and degree of disease control are the major drivers of its clinical and economic impact. National scientific societies are required to monitor the application of international guidelines and to adopt strategies to improve disease control and better allocate resources. AIM to provide a detailed picture of the characteristics of asthma patients and modalities of asthma management by specialists in Italy and to develop recommendations for the daily management of asthma in a specialist setting. METHOD A quantitative research program was implemented. Data were collected using an ad hoc questionnaire developed by a group of specialists selected by the Italian Pneumology Society/Italian Respiratory Society. RESULTS The records of 557 patients were analyzed. In the next few years, specialists are expected to focus their activity patients with more severe disease and will be responsible for selection of patients for personalized biological therapy; however, only 20% of patients attending Italian specialist surgery can be considered severe. In 84.4% of cases, the visit was a follow-up visit requested in 82.2% of cases by the specialist him/herself. The Asthma Control Test is used only in 65% of patients. When available, a significant association has been observed between the test score and asthma control as judged by the physician, although concordance was only moderate (κ = 0.68). Asthma was considered uncontrolled by the specialist managing the case in 29.1% of patients; nevertheless, treatment was not stepped up in uncontrolled or partly controlled patients (modified in only 37.2% of patients). CONCLUSIONS The results of this survey support re-evaluation of asthma management by Italian specialists. More resources should be made available for the initial visit and for more severely ill patients. In addition, more extensive use should be made of validated tools, and available drugs should be used more appropriately.
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Affiliation(s)
- Fulvio Braido
- Allergy & Respiratory Diseases, Department of Internal Medicine- University of Genoa, Italy.
| | - Ilaria Baiardini
- Allergy & Respiratory Diseases, Department of Internal Medicine- University of Genoa, Italy
| | - Pietro Alleri
- Servizio di Riabilitazione Respiratoria e prevenzione Tisiopneumologica USL, Perugia, Umbria 1, Italy
| | - Elena Bacci
- Cardio-Thoracic and Vascular Department, University of Pisa, Italy
| | - Carlo Barbetta
- Section of Respiratory Diseases Department of Medical Sciences - University of Ferrara, Italy
| | | | - Alida Benfante
- Department of Internal Medicine, University of Palermo, Italy
| | - Francesco Blasi
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Cardio-thoracic unit and Cystic Fibrosis Adult Center Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico Milano, Italy
| | | | - Maria Teresa Busceti
- Department of Medical and Surgical Sciences, Section of Respiratory Diseases, University "Magna Græcia" of Catanzaro, Italy
| | - Stefano Centanni
- Respiratory Unit, San Paolo Hospital, Department of Medical Sciences, University of Milan, Milan, Italy
| | - Maria Cristina Colanardi
- Malattie Apparato Respiratorio. Universitaria Azienda Ospedaliero-universitaria Ospedali Riuniti di Foggia, Italy
| | - Marco Contoli
- Section of Respiratory Diseases Department of Medical Sciences - University of Ferrara, Italy
| | - Angelo Corsico
- Pneumology Unit, Department of Internal Medicine and Medical Therapy, San Matteo Polyclinic and Institute for Scientific Research, University of Pavia, Italy
| | - Maria D'Amato
- Unit of Pneumotisiology, Monaldi-AO Dei Colli Hospital, Federico II University, Naples, Italy
| | - Fabiano Di Marco
- Respiratory Unit, San Paolo Hospital, Department of Medical Sciences, University of Milan, Milan, Italy
| | - Dottorini Marco
- Servizio di Riabilitazione Respiratoria e prevenzione Tisiopneumologica USL, Perugia, Umbria 1, Italy
| | - Marta Ferrari
- Allergy & Respiratory Diseases, Department of Internal Medicine- University of Genoa, Italy
| | | | | | | | - Garuti Silvia
- Allergy & Respiratory Diseases, Department of Internal Medicine- University of Genoa, Italy
| | - Giuseppe Girbino
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Section of Respiratory Diseases, University of Messina, Policlinico Universitario "G.Martino", Messina, Italy
| | - Amelia Grosso
- Department of Internal Medicine and Medical Therapy, University of Pavia, Italy
| | - Manuela Latorre
- Cardio-Thoracic and Vascular Department, University of Pisa, Italy
| | - Sara Maniscalco
- Pulmonology Department, Santa Corona Hospital, Pietra Ligure, Savona, Italy
| | | | - Carlo Mereu
- Pulmonology Department, Santa Corona Hospital, Pietra Ligure, Savona, Italy
| | | | - Josuel Ora
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | | | - Vincenzo Patella
- Allergy and Clinical Immunology Division, Battipaglia Hospital, Department of Medicine ASL Salerno, Italy
| | - Girolamo Pelaia
- Department of Medical and Surgical Sciences, Section of Respiratory Diseases, University "Magna Græcia" of Catanzaro, Italy
| | - Pietro Pirina
- Department of Respiratory Diseases, Azienda Ospedaliero Universitaria di Sassari, Italy
| | - Alfio Proietto
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Section of Respiratory Diseases, University of Messina, Policlinico Universitario "G.Martino", Messina, Italy
| | - Paola Rogliani
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Pierachille Santus
- University of Milan, Respiratory Unit, L. Sacco Hospital, ASST Fatebenefratelli Sacco, Milano, Italy
| | | | | | | | - Silvia Terraneo
- Respiratory Unit, San Paolo Hospital, Department of Medical Sciences, University of Milan, Milan, Italy
| | | | - Giorgio Walter Canonica
- Personalized Medicine Clinic: Asthma & Allergy - Humanitas Clinical and Research Center, Department of Biomedical Science, Humanitas University -Rozzano Milano, Italy
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