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Asthma

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Bo Lundback – 1st expert on this subject based on the ideXlab platform

  • The Significance of Asthma Follow-Up Consultations for Adherence to Asthma Medication, Asthma Medication Beliefs, and Asthma Control
    Nursing Research and Practice, 2015
    Co-Authors: Malin Axelsson, Linda Ekerljung, Bo Lundback

    Abstract:

    Objective. The aim was to investigate adherence to Asthma medication treatment, medication beliefs, and Asthma control in relation to Asthma follow-up consultations in Asthmatics in the general population. A further aim was to describe associations between adherence, medication beliefs, and Asthma control. Method. In the population-based West Sweden Asthma Study, data allowing calculation of adherence for 4.5 years based on pharmacy records were obtained from 165 adult Asthmatics. Additional data were collected through questionnaires and structured interviews. Results. The mean adherence value for filled prescriptions for regular Asthma medication was 68% (median 55.3%) but varied over the year under study. Adherence to combination inhalers with corticosteroids and long-acting beta2 agonists was higher than adherence to single inhalers with corticosteroids only. More than one-third of participants reported not having seen an Asthma nurse or physician for several years. Regular Asthma follow-up consultations were associated with both higher adherence and the belief that Asthma medication was necessary but were not associated with Asthma control. Conclusions. Adherence to Asthma medication treatment was low and varied over the year under study. The current study suggests that quality improvements in Asthma care are needed if adherence to Asthma medication is to be improved.

  • Asthma control, emergency visits, lung function and FENO in Asthma and non-Asthma in the West Sweden Asthma Study (WSAS)
    Clinical and Translational Allergy, 2013
    Co-Authors: Jan Lötvall, Linda Ekerljung, Anders Bjerg, Bo Lundback

    Abstract:

    WSAS is a clinical epidemiological study, based on a random population of 30000 individuals living in West Sweden. After having answered a questionnaires, a random population was invited to extensive clinical phenotyping. We here report lung function FENO data from 954 Asthmatics and 1030 non-Asthmatics. Asthma was defined as “doctors diagnosis of Asthma” and “ever Asthma” + “current Asthma medication or symptoms common in Asthma”. According to GINA criteria, 57.6% of Asthmatics had controlled Asthma, 29.3% partly controlled Asthma and, 13.1% uncontrolled Asthma. Weekly night-time Asthma awakenings was reported by 12.6% of Asthmatics. The prevalence of emergency visits over the last year due to Asthma was 13.9% in non-smokers, 17.1% in ex-smokers, and 31.6 in current smokers (p=0.006 for trend). Mean %pred FEV1 was 105.3% in non-Asthma and 96.9 in Asthma. In the non-Asthma group, 29.4% of individuals had FEV1 50 ppb) was observed in 3% of the non-Asthma group and 9.6% of the Asthma group. Asthma with significant severity, leading to emergency visits, is common in the WSAS, and previous or current smoking increase that risk. Furthermore, close to every other individual with Asthma report uncontrolled or partly controlled disease. Despite significant disease severity in this epidemiological setting, very few Asthmatics express low lung function or very high exhaled FENO. Neither FEV1, nor FENO may be appropriate markers of disease severity in an epidemiological setting. However, WSAS may be utilized to further explore determinants of Asthma severity and their risk factors, which will be reported at the meeting. This work was financed by the VBG Foundation against Asthma/allergy.

  • multi symptom Asthma is closely related to nasal blockage rhinorrhea and symptoms of chronic rhinosinusitis evidence from the west sweden Asthma study
    Respiratory Research, 2010
    Co-Authors: Jan Lötvall, Linda Ekerljung, Bo Lundback

    Abstract:

    Background: We have previously shown that approximately 25% of those with Asthma in West Sweden have multiple Asthma symptoms, which may describe a group of patients with more severe disease. Furthermore, Asthma is associated with several co-morbid diseases, including rhinitis and chronic rhinosinusitis. The aim of this study was to determine whether multi-symptom Asthma is related to signs of severe Asthma, and to investigate the association between multi-symptom Asthma and different symptoms of allergic and chronic rhinosinusitis. Methods: This study analyzed data on Asthma symptoms, rhinitis, and chronic rhinosinusitis from the 2008 West Sweden Asthma Study, which is an epidemiologically based study using the OLIN and GA 2 LEN respiratory and allergy focused questionnaires. Results: Multi-symptom Asthma was present in 2.1% of the general population. Subjects with multi-symptom Asthma had more than double the risk of having night-time awakenings caused by Asthma compared with those with fewer Asthma symptoms (P < 0.001). The prevalence of allergic rhinitis was similar in the fewer- and multisymptom Asthma groups, but nasal blockage and rhinorrhea were significantly increased in those with multiversus fewer-symptom Asthma (odds ratio 2.21; 95% confidence interval 1.64-2.97, versus 1.49; 1.10-2.02, respectively). Having any, or one to four symptoms of chronic rhinosinusitis significantly increased the risk of having multi- versus fewer-symptom Asthma (P < 0.01). Conclusion: An epidemiologically identified group of individuals with multiple Asthma symptoms harbour to greater extent those with signs of severe Asthma. The degree of rhinitis, described by the presence of symptoms of nasal blockage or rhinorrhea, as well as the presence of any or several signs of chronic rhinosinusitis, significantly increases the risk of having multi-symptom Asthma.

Jeanne E Moorman – 2nd expert on this subject based on the ideXlab platform

  • Age at Asthma onset and subsequent Asthma outcomes among adults with active Asthma.
    Respiratory Medicine, 2013
    Co-Authors: Maria C. Mirabelli, Suzanne F. Beavers, Arjun B. Chatterjee, Jeanne E Moorman

    Abstract:

    Summary Introduction Little is known about the extent to which the age at which Asthma first began influences respiratory health later in life. We conducted these analyses to examine the relationship between age at Asthma onset and subsequent Asthma-related outcomes. Methods We used data from 12,216 adults with Asthma who participated in the 2010 Behavioral Risk Factor Surveillance System Asthma Call-back Survey to describe the distribution of age at Asthma onset. Linear regression was used to estimate associations of age at Asthma onset with Asthma-related outcomes, including symptoms in the past 30 days and Asthma-related emergency visits. Results Asthma onset before age 16 was reported by an estimated 42% of adults with active Asthma, including 14% with onset at 5–9 years of age who reported experiencing any Asthma symptoms on 21% of days in the past month. Compared to this group, the percentage of days in the past month with any Asthma symptoms was 14.8% higher (95% confidence interval (CI): 5.4, 24.1) among those whose Asthma onset occurred at Conclusion Age at Asthma onset may affect subsequent Asthma-related outcomes.

  • Asthma symptoms among adults with work-related Asthma.
    Journal of Asthma, 2012
    Co-Authors: Gretchen E. Knoeller, Jacek M. Mazurek, Jeanne E Moorman

    Abstract:

    Objective. To examine the number of days with Asthma symptoms among individuals with work-related Asthma (WRA) and non-WRA. Methods. We calculated adjusted prevalence ratios and compared mean number of days with Asthma symptoms using 2006–2009 Behavioral Risk Factor Surveillance System Asthma Call-back Survey data for ever-employed adults with current Asthma from 38 states and District of Columbia. Results. Compared with persons with non-WRA, those with WRA had higher mean number of days with Asthma symptoms. Regardless of WRA status, individuals with higher number of days with Asthma symptoms were more likely to be unable to work or carry out their usual activities due to Asthma. Associations between frequency of Asthma symptoms and activity limitation due to Asthma were weaker among currently employed adults and stronger among adults not currently employed than the observed associations for all ever-employed adults. Conclusions. These results suggest higher frequency of Asthma symptoms among adults with…

  • trends in Asthma prevalence health care use and mortality in the united states 2001 2010
    NCHS data brief, 2012
    Co-Authors: Lara J Akinbami, Hatice S Zahran, Jeanne E Moorman, Cathy M Bailey, Michele King, Carol A Johnson

    Abstract:

    : Asthma prevalence increased from 2001 to 2010: An estimated 25.7 million persons had Asthma in 2010. Certain demographic groups had higher Asthma prevalence: children aged 0–17 years, females, black persons, persons of multiple race, Puerto Rican persons, and persons with a family income below the poverty level. This report examines rates for Asthma outcomes (health care encounters and death) for persons with Asthma rather than for the general population. Rates for the general population represent the burden of Asthma in the United States. Rates for the population with Asthma take into account changes in Asthma prevalence over time and differences in Asthma prevalence among demographic groups. From 2001 to 2009, rates for ED visits and hospitalizations per 100 persons with Asthma remained stable, while rates for Asthma visits in primary care settings (physician offices or hospital outpatient departments) and Asthma deaths declined. For the period 2007–2009, Asthma visit rates (per 100 persons with Asthma) in primary care settings for black persons were similar to those for white persons, but rates for Asthma ED visits, hospitalizations, and death (per 1,000) were higher. Compared with adults, children aged 0–17 years had a higher rate for Asthma visits in primary care settings and EDs, but had a similar hospitalization rate and a lower Asthma death rate.

Jan Lötvall – 3rd expert on this subject based on the ideXlab platform

  • EAACI position statement on Asthma exacerbations and severe Asthma
    Allergy, 2013
    Co-Authors: Adnan Custovic, Ian D Pavord, Jan Lötvall, Pascal Demoly, Sebastian L. Johnston, Mina Gaga, Leonardo M. Fabbri, P. N. Le Souëf, Cezmi A. Akdis

    Abstract:

    Asthma exacerbations and severe Asthma are linked with high morbidity, significant mortality and high treatment costs. Recurrent Asthma exacerbations cause a decline in lung function and, in childhood, are linked to development of persistent Asthma. This position paper, from the European Academy of Allergy and Clinical Immunology, highlights the shortcomings of current treatment guidelines for patients suffering from frequent Asthma exacerbations and those with difficult-to-treat Asthma and severe treatment-resistant Asthma. It reviews current evidence that supports a call for increased awareness of (i) the seriousness of Asthma exacerbations and (ii) the need for novel treatment strategies in specific forms of severe treatment-resistant Asthma. There is strong evidence linking Asthma exacerbations with viral airway infection and underlying deficiencies in innate immunity and evidence of a synergism between viral infection and allergic mechanisms in increasing risk of exacerbations. Nonadherence to prescribed medication has been identified as a common clinical problem amongst adults and children with difficult-to-control Asthma. Appropriate diagnosis, assessment of adherence and other potentially modifiable factors (such as passive or active smoking, ongoing allergen exposure, psychosocial factors) have to be a priority in clinical assessment of all patients with difficult-to-control Asthma. Further studies with improved designs and new diagnostic tools are needed to properly characterize (i) the pathophysiology and risk of Asthma exacerbations, and (ii) the clinical and pathophysiological heterogeneity of severe Asthma.

  • Asthma control, emergency visits, lung function and FENO in Asthma and non-Asthma in the West Sweden Asthma Study (WSAS)
    Clinical and Translational Allergy, 2013
    Co-Authors: Jan Lötvall, Linda Ekerljung, Anders Bjerg, Bo Lundback

    Abstract:

    WSAS is a clinical epidemiological study, based on a random population of 30000 individuals living in West Sweden. After having answered a questionnaires, a random population was invited to extensive clinical phenotyping. We here report lung function FENO data from 954 Asthmatics and 1030 non-Asthmatics. Asthma was defined as “doctors diagnosis of Asthma” and “ever Asthma” + “current Asthma medication or symptoms common in Asthma”. According to GINA criteria, 57.6% of Asthmatics had controlled Asthma, 29.3% partly controlled Asthma and, 13.1% uncontrolled Asthma. Weekly night-time Asthma awakenings was reported by 12.6% of Asthmatics. The prevalence of emergency visits over the last year due to Asthma was 13.9% in non-smokers, 17.1% in ex-smokers, and 31.6 in current smokers (p=0.006 for trend). Mean %pred FEV1 was 105.3% in non-Asthma and 96.9 in Asthma. In the non-Asthma group, 29.4% of individuals had FEV1 50 ppb) was observed in 3% of the non-Asthma group and 9.6% of the Asthma group. Asthma with significant severity, leading to emergency visits, is common in the WSAS, and previous or current smoking increase that risk. Furthermore, close to every other individual with Asthma report uncontrolled or partly controlled disease. Despite significant disease severity in this epidemiological setting, very few Asthmatics express low lung function or very high exhaled FENO. Neither FEV1, nor FENO may be appropriate markers of disease severity in an epidemiological setting. However, WSAS may be utilized to further explore determinants of Asthma severity and their risk factors, which will be reported at the meeting. This work was financed by the VBG Foundation against Asthma/allergy.

  • multi symptom Asthma is closely related to nasal blockage rhinorrhea and symptoms of chronic rhinosinusitis evidence from the west sweden Asthma study
    Respiratory Research, 2010
    Co-Authors: Jan Lötvall, Linda Ekerljung, Bo Lundback

    Abstract:

    Background: We have previously shown that approximately 25% of those with Asthma in West Sweden have multiple Asthma symptoms, which may describe a group of patients with more severe disease. Furthermore, Asthma is associated with several co-morbid diseases, including rhinitis and chronic rhinosinusitis. The aim of this study was to determine whether multi-symptom Asthma is related to signs of severe Asthma, and to investigate the association between multi-symptom Asthma and different symptoms of allergic and chronic rhinosinusitis. Methods: This study analyzed data on Asthma symptoms, rhinitis, and chronic rhinosinusitis from the 2008 West Sweden Asthma Study, which is an epidemiologically based study using the OLIN and GA 2 LEN respiratory and allergy focused questionnaires. Results: Multi-symptom Asthma was present in 2.1% of the general population. Subjects with multi-symptom Asthma had more than double the risk of having night-time awakenings caused by Asthma compared with those with fewer Asthma symptoms (P < 0.001). The prevalence of allergic rhinitis was similar in the fewer- and multisymptom Asthma groups, but nasal blockage and rhinorrhea were significantly increased in those with multiversus fewer-symptom Asthma (odds ratio 2.21; 95% confidence interval 1.64-2.97, versus 1.49; 1.10-2.02, respectively). Having any, or one to four symptoms of chronic rhinosinusitis significantly increased the risk of having multi- versus fewer-symptom Asthma (P < 0.01). Conclusion: An epidemiologically identified group of individuals with multiple Asthma symptoms harbour to greater extent those with signs of severe Asthma. The degree of rhinitis, described by the presence of symptoms of nasal blockage or rhinorrhea, as well as the presence of any or several signs of chronic rhinosinusitis, significantly increases the risk of having multi-symptom Asthma.