Addressing sex and gender to improve asthma management

Boulet, Louis‐Philippe; Lavoie, Kim L.; Raherison‐Semjen, Chantal; Kaplan, Alan; Singh, Dave; Jenkins, Christine

doi:10.1038/s41533-022-00306-7

Cited by 18 publications

(11 citation statements)

References 88 publications

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“…Despite this, we did achieve a postrandomization balance in recorded characteristics at baseline, indicating successful randomization. Most of the participants were female, reflecting established differences in sex-specific rates of asthma [ 42 ], health behaviors, and health care use in adults [ 43 ].…”

Section: Discussionmentioning

confidence: 99%

Digital Self-Management Platform for Adult Asthma: Randomized Attention-Placebo Controlled Trial

Kandola,

Edwards,

Straatman

et al. 2024

J Med Internet Res

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Background Asthma is one of the most common chronic conditions worldwide, with a substantial individual and health care burden. Digital apps hold promise as a highly accessible, low-cost method of enhancing self-management in asthma, which is critical to effective asthma control. Objective We conducted a fully remote randomized controlled trial (RCT) to assess the efficacy of juli, a commercially available smartphone self-management platform for asthma. Methods We conducted a pragmatic single-blind, RCT of juli for asthma management. Our study included participants aged 18 years and older who self-identified as having asthma and had an Asthma Control Test (ACT) score of 19 or lower (indicating uncontrolled asthma) at the beginning of the trial. Participants were randomized (1:1 ratio) to receive juli for 8 weeks or a limited attention-placebo control version of the app. The primary outcome measure was the difference in ACT scores after 8 weeks. Secondary outcomes included remission (ACT score greater than 19), minimal clinically important difference (an improvement of 3 or more points on the ACT), worsening of asthma, and health-related quality of life. The primary analysis included participants using the app for 8 weeks (per-protocol analysis), and the secondary analysis used a modified intention-to-treat (ITT) analysis. Results We randomized 411 participants between May 2021 and April 2023: a total of 152 (37%) participants engaged with the app for 8 weeks and were included in the per-protocol analysis, and 262 (63.7%) participants completed the week-2 outcome assessment and were included in the modified ITT analysis. Total attrition between baseline and week 8 was 259 (63%) individuals. In the per-protocol analysis, the intervention group had a higher mean ACT score (17.93, SD 4.72) than the control group (16.24, SD 5.78) by week 8 (baseline adjusted coefficient 1.91, 95% CI 0.31-3.51; P=.02). Participants using juli had greater odds of achieving or exceeding the minimal clinically important difference at 8 weeks (adjusted odds ratio 2.38, 95% CI 1.20-4.70; P=.01). There were no between group differences in the other secondary outcomes at 8 weeks. The results from the modified ITT analyses were similar. Conclusions Users of juli had improved asthma symptom control over 8 weeks compared with users of a version of the app with limited functionality. These findings suggest that juli is an effective digital self-management platform that could augment existing care pathways for asthma. The retention of patients in RCTs and real-world use of digital health care apps is a major challenge. Trial Registration International Standard Randomised Controlled Trial Number (ISRCTN) registry ISRCTN87679686; https://www.isrctn.com/ISRCTN87679686

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Section: Discussionmentioning

confidence: 99%

Digital Self-Management Platform for Adult Asthma: Randomized Attention-Placebo Controlled Trial

Kandola,

Edwards,

Straatman

et al. 2024

J Med Internet Res

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“…This sex difference in asthma control has been demonstrated previously in adults 19 and adolescents 20 and is suggested to be caused by sex-specific physiologic differences and sex-specific behavioral differences. 21 Standardized questionnaires such as the ACT are useful tools to assess asthma symptoms. Still, the ACT is insufficient for a complete assessment of asthma control, as exacerbations and pulmonary function are not included.…”

Section: Discussionmentioning

confidence: 99%

Uncontrolled asthma in school-aged children—a nationwide specialist care study

Stridsman,

Martinsen,

Selberg

et al. 2024

Journal of Allergy and Clinical Immunology: Global

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“…17 Men are more likely to be exposed to pyrolysis products, plant-based materials, isocyanates, metals, and metalloids. 18 It is thought that the stimuli causing occupational asthma are also different due to the fact that men and women work in different work environments. In this study, unlike the literature, occupational asthma was found to lead to higher mortality and DALYs in men.…”

Section: Discussionmentioning

confidence: 99%

The evaluation of asthma by gender and age groups in Turkey, in 1990-2019: incidence, prevalence, mortality, and disability-adjusted life years

Dinçer¹,

Kocakaya²,

AKYOL³

2023

JOPIC

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Aims: The aim of this study was to evaluate the incidence and prevalence of asthma, asthma-related DALYs and deaths, and risk factors for asthma by genders and age groups during the study years in Turkey. Methods: The data used in the study were obtained from the estimation data prepared by the Institute for Health Metrics and Evaluation on asthma for Turkey by the global burden of disease study covering the years 1990-2019. During the study years period, death from asthma and Disability-Adjusted Life Years (DALYs) were used as dependent variables. In addition, the effects of Occupational Asthmagens (OA), Smoking (SM), and High Body Mass Index (HBMI), which are known as risk factors for asthma-related deaths and DALYs, were investigated. Comparisons of the variables according to gender and age groups were made with the Mann-Whitney test. The relationships between the variables were examined with the Spearman rank correlation coefficient (Rho). Results: A statistically significant difference was found between the mean rank of total prevalence number, total incidence number, total number of deaths and DALYs scores by gender. Asthma-related deaths due to risk factors (OA, HBMI, SM) were found to be correlated with DALYs and the total number of asthma deaths. Total asthma deaths, and asthma-related deaths because of HBMI and DALYs because of HBMI-induced asthma in women; deaths from asthma because of OA, SM, and DALYs from asthma because of OA and SM were found to be higher in males. Conclusion: HBMI in women and SM and OA in men stand out as risk factors. Therefore, as a result of a detailed investigation of the risk factors leading to the development of asthma, policies should be developed for gender and age groups, and necessary precautions should be taken.

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Addressing sex and gender to improve asthma management

Cited by 18 publications

References 88 publications

Digital Self-Management Platform for Adult Asthma: Randomized Attention-Placebo Controlled Trial

Digital Self-Management Platform for Adult Asthma: Randomized Attention-Placebo Controlled Trial

Uncontrolled asthma in school-aged children—a nationwide specialist care study

The evaluation of asthma by gender and age groups in Turkey, in 1990-2019: incidence, prevalence, mortality, and disability-adjusted life years

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