A systematic literature review of burden of illness in adults with uncontrolled moderate/severe asthma

Czira, Alexandrosz; Turner, M.; Martin, Amber; Hinds, David; Birch, H.; Gardiner, Frances; Zhang, Shiyuan

doi:10.1016/j.rmed.2021.106670

Cited by 32 publications

(22 citation statements)

References 138 publications

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“…Three out of ten patients reported not having used any healthcare resource in the year prior to the study, and a considerable proportion of patients (40.8%) did not attend to any routine medical appointment in the same period, which goes against the asthma management recommendations that advocate each patient should have an asthma review at least once a year. 27 Unscheduled medical appointments, [28][29][30] Emergency Department visits (particularly among non-OCS users), 28,30,31 and hospitalizations 29,30,32 were also less frequent than reported by other studies. In fact, only 18% of the participants visited the ED due to asthma in the previous year, a lower proportion than that reported by step 3+ patients using a short-acting beta agonist (SABA) inhaler (45%) in a previous study conducted in Portugal.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of Oral Corticosteroid Users Among Persons with Asthma on GINA Step 3 Therapy and Above: A Cross-Sectional Study in Portuguese Community Pharmacies

Romão¹,

Bulhosa²,

Mendes³

et al. 2022

JAA

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Oral corticosteroids (OCS) are frequently used in asthma management but have an important risk-profile. The aim of the study is to characterize and compare the sociodemographic and clinical characteristics, treatment regimen and asthma control between OCS users and non-users among the population of asthma patients (≥18 years) at GINA step 3 and above treated with a fixed combination of an inhaled corticosteroid and a long-acting beta-agonist (ICS/LABA). Methods: Cross-sectional study in Portuguese community pharmacies. Data was collected via paper-based interview delivered at the pharmacy (sociodemographic characteristics and asthma treatment regimen, namely ICS/LABA and OCS utilization), followed by a telephonic interview collecting smoking history, comorbidities, body mass index (BMI), history of exacerbations and asthma-related healthcare resource utilization (HCRU) in the previous 12 months, as well as asthma control using the Control of Allergic Rhinitis and Asthma Test (CARAT®). Results: A total of 347 patients recruited in 98 pharmacies were included in the analysis. Of those, 328 had completed both questionnaires. A quarter of the individuals reported OCS use in the previous 12 months (OCS users), either as add-on therapy (6%) or exacerbation treatment (19%). Patients were mostly females (72%), with an average age of 59.5 years (SD=15.4). OCS users were significantly older and reported more frequently having conjunctivitis (25.9% vs 15.0%), osteoporosis (25.9% vs 13.4%), arthritis (14.6% vs 6.9%), and gastrointestinal disease (16.1% vs 8.1%). OCS users also reported greater urgent HCRU: unscheduled consultations (33.3% vs 9.3%) and emergency department (ED) visits (32.1% vs 12.1%). Both groups presented poor disease control (85.2% of OCS users vs 72.9% of non-OCS users). Conclusion: These results highlight the burden of OCS therapy to asthma patients and the need to improve asthma management, by adopting OCS sparing strategies in this subgroup of patients.

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Section: Discussionmentioning

confidence: 99%

Characteristics of Oral Corticosteroid Users Among Persons with Asthma on GINA Step 3 Therapy and Above: A Cross-Sectional Study in Portuguese Community Pharmacies

Romão¹,

Bulhosa²,

Mendes³

et al. 2022

JAA

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“…Adult human lung disease inflicts a large socio-economic burden and is a leading cause of morbidity and mortality worldwide (Refs 20 , 21 , 22 , 23 ). This includes acute lung disease in response to viral (e.g., influenza, rhinovirus (RV), SARS-CoV-2) or bacterial (e.g., Streptococcus, Haemophilus, Pseudomonas) infections and chronic respiratory diseases, such as chronic obstructive pulmonary disease (COPD), asthma, idiopathic pulmonary fibrosis (IPF), pulmonary arterial hypertension (PAH) (Refs 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 ).…”

Section: Introductionmentioning

confidence: 99%

The emerging role of NOTCH3 receptor signalling in human lung diseases

Bodas

Bharathiraja

Karmouty‐Quintana

et al. 2022

Expert Rev. Mol. Med.

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The mammalian respiratory system or lung is a tree-like branching structure, and the main site of gas exchange with the external environment. Structurally, the lung is broadly classified into the proximal (or conducting) airways and the distal alveolar region, where the gas exchange occurs. In parallel with the respiratory tree, the pulmonary vasculature starts with large pulmonary arteries that subdivide rapidly ending in capillaries adjacent to alveolar structures to enable gas exchange. The NOTCH signalling pathway plays an important role in lung development, differentiation and regeneration post-injury. Signalling via the NOTCH pathway is mediated through activation of four NOTCH receptors (NOTCH1-4), with each receptor capable of regulating unique biological processes. Dysregulation of the NOTCH pathway has been associated with development and pathophysiology of multiple adult acute and chronic lung diseases. This includes accumulating evidence that alteration of NOTCH3 signalling plays an important role in the development and pathogenesis of chronic obstructive pulmonary disease, lung cancer, asthma, idiopathic pulmonary fibrosis and pulmonary arterial hypertension. Herein, we provide a comprehensive summary of the role of NOTCH3 signalling in regulating repair/regeneration of the adult lung, its association with development of lung disease and potential therapeutic strategies to target its signalling activity.

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“…in case of uncertain diagnosis or severe or uncontrolled disease. Despite the advances in asthma understanding and management in recent decades, poor asthma control is prevalent in more than one in three patients with severe asthma and one in four with mild–moderate asthma in Scandinavia [ 3 – 5 ], with major consequences for patients’ quality of life, as well as societal costs [ 5 – 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…A great deal of inappropriate OCS use occurs in mild–moderate asthma which may be poorly controlled due to underuse of ICS and/or poor adherence [ 9 , 16 ]. The most important problem in suboptimally treated asthma is recurrent exacerbations, decline of pulmonary function and OCS-associated side-effects [ 5 , 7 , 16 ]. Growing evidence suggests that receiving even a few OCS courses is associated with long-term side-effects in general asthma populations [ 9 , 17 – 19 ], emphasising a need for easy-to-recall red flags for the identification of at-risk patients in broader asthma populations who would benefit from a second opinion from a specialist.…”

Section: Introductionmentioning

confidence: 99%

Trends and predictors of specialist assessments in oral corticosteroid treated asthma among young adults

et al. 2022

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BackgroundRepeated oral corticosteroid use indicates uncontrolled disease among asthma patients and referral for asthma specialist assessment is recommended. We aimed to describe trends and predictors associated with specialist contacts among young adults with asthma and repeated oral corticosteroid use.MethodsIndividuals aged 18–45 years with ≥2 dispensed asthma medication prescriptions and two dispended oral corticosteroid prescriptions (including short-term and long-term treatments) within 12 months during 1999–2018 were identified by use of Danish healthcare registers. The frequency of specialist contacts within 1 year of follow-up was assessed among individuals without previous specialist contacts within 5 years of inclusion. Factors associated with specialist contact were identified by logistic regression models. Furthermore, oral corticosteroid prescriber sources were assessed.ResultsFor the 11 223 individuals included, 2444 (22%) had previous specialist contacts care within 5 years prior of inclusion and additionally 926 (8.3%) within 1 year of follow-up. Among those without previous specialist contacts (n 8779), the frequency of incident specialist contacts within 1 year of follow-up increased from 6.3% in 1999 to 18% in 2017. Factors associated with incident specialist contacts included dispensing ≥12 SABA canisters and previous asthma-related emergency department visits and hospitalisations. The majority of oral corticosteroid prescriptions at baseline (71%) were prescribed by general practitioners, though with decreasing proportions from 1999–2018.ConclusionsThe majority (70%) of young adults with asthma and repeated oral corticosteroid use do not seem to receive specialist assessment in Denmark. This highlights a potential room for improvement in the patient referral pathway for at-risk asthma patients.

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A systematic literature review of burden of illness in adults with uncontrolled moderate/severe asthma

Cited by 32 publications

References 138 publications

Characteristics of Oral Corticosteroid Users Among Persons with Asthma on GINA Step 3 Therapy and Above: A Cross-Sectional Study in Portuguese Community Pharmacies

Characteristics of Oral Corticosteroid Users Among Persons with Asthma on GINA Step 3 Therapy and Above: A Cross-Sectional Study in Portuguese Community Pharmacies

The emerging role of NOTCH3 receptor signalling in human lung diseases

Trends and predictors of specialist assessments in oral corticosteroid treated asthma among young adults

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