An audit of morbidity associated with chronic asthma in general practice

Horn, C.R.; Cochrane, G. M.

doi:10.1016/s0954-6111(89)80063-0

Cited by 26 publications

(12 citation statements)

References 12 publications

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“…Its prevalence is increasing, and despite a clearer understanding of its pathogenesis, morbidity and mortality from the disease remain high. [1][2][3] Most patients with asthma receive their care in the community, where a large number of general practices have responded by providing an increasing number of clinics, often led by specialist practice nurses. 4 5 Despite this increase in service provision, recent surveys have shown that about half of all asthmatics continue to have night symptoms, and of that group, about half have such symptoms most nights.…”

Section: Introductionmentioning

confidence: 99%

A comparison of professionals' and patients' understanding of asthma: evidence of emerging dualities?: Table 1

Sweeney

Edwards²,

Stead³

et al. 2001

Med Humanities

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Section: Introductionmentioning

confidence: 99%

A comparison of professionals' and patients' understanding of asthma: evidence of emerging dualities?: Table 1

Sweeney

Edwards²,

Stead³

et al. 2001

Med Humanities

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“…Respiratory system disorders were reported most frequently followed by nervous system and digestive system disorders (table 5). Thirty one patients (11%, 44 reports) experienced an adverse event classified as serious (including any event leading to the withdrawal of study medication) during salmeterol treatment in the total study population, compared with 17 patients (12%, 25 reports) in the placebo group (table 5). The numbers of patients who withdrew due to adverse events related to asthma were similar in both groups (eight (3%) in the salmeterol group and six (4%) in the placebo group).…”

Section: Safety Resultsmentioning

confidence: 99%

Salmeterol xinafoate in the treatment of mild to moderate asthma in primary care. UK Study Group.

Jones

1994

Thorax

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Results -A total of 427 asthmatic patients aged 18 years or older were randomised to receive salmeterol or placebo in a 2:1 ratio. Of the total randomised population, 247 patients were previously on short acting bronchodilators alone whilst 180 patients were concurtently receiving up to 400 ,tg inhaled corticosteroid. Mean morning peak expiratory flow rose more in the salmeterol group than in the placebo group (treatment difference 17 1min, 95% confidence interval 9 to 26 I/min) but there was a smaller, non-significant difference in mean evening peak expiratory flow. Improvements occurred in the salmeteroltreated group compared with placebo for wheeze, shortness of breath, undisturbed nights, and relief medication use, irrespective of concomitant inhaled corticosteroid use. In addition, improvement in activity restriction was seen in the salmeterol group compared with placebo in the subgroup receiving only bronchodilator.Conclusions -Salmeterol is effective and well tolerated in the short term in mildly asthmatic adult patients irrespective of concomitant use of inhaled corticosteroid therapy.

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“…Recording the three cardinal daytime asthma symptoms would, for example, take into account the symptomatology of a patient who coughed but did not feel breathless. Daily symptom frequency is only one of several alternative ways, including visual analogue scales [11], symptom severity and morbidity indices [9,10], to assess the severity of asthma.…”

Section: Discussionmentioning

confidence: 99%

“…In these closely monitored conditions, only a moderate correlation between the perception of breathlessness and lung function has been shown. In general practice, HORN and COCHRANE [9] reported, on the basis of a single interview, a poor correlation (Pearson r=-0.22) between the patients' assessment of breathlessness severity over the preceding year on a visual analogue scale and forced expiratory volume in one second (FEV1). JONES et al [10], on the other hand, found a significant association between mean peak flow rate (PFR) and a three point morbidity index in general practice.…”

mentioning

confidence: 99%

Relationship of daytime asthma symptom frequency to morning peak expiratory flow

Atherton

White²,

Hewett³

et al. 1996

Eur Respir J

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Since management plans based on peak flow measurements are increasingly used, the relationship between peak flow rate and ensuing symptom frequency is of particular interest to the treatment of asthma. The objective of this study was to examine to what extent morning peak flow was related to symptom frequency during the day.In 168 out of 307 randomly selected adult asthmatics from a general practice population, adequate recordings of morning peak flow (amPF) and symptom frequency during the day (DSF) were obtained for 28 days. In each individual, the relationship between these two variables was studied and the mean values of these two variables over 28 days were calculated. The relationship between the means of the variables was also examined for the group as a whole.In individuals, the correlation between amPF and DSF varied widely; only 16% of patients had a good relationship (Pearson r -1 to -0.5). For the whole group, the relationship between mean amPF and mean DSF best fitted a curvilinear model (r -0.6). This was unaffected by age, sex or the use of inhaled steroids.For the majority of asthmatics, morning peak flow may be an unreliable predictor of expected symptoms during that day. Reliance on peak flow measurement as a tool enabling asthmatics to manage their asthma on a daily basis needs to be reconsidered.

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An audit of morbidity associated with chronic asthma in general practice

Cited by 26 publications

References 12 publications

A comparison of professionals' and patients' understanding of asthma: evidence of emerging dualities?: Table 1

A comparison of professionals' and patients' understanding of asthma: evidence of emerging dualities?: Table 1

Salmeterol xinafoate in the treatment of mild to moderate asthma in primary care. UK Study Group.

Relationship of daytime asthma symptom frequency to morning peak expiratory flow

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