Asthma control in adults in the Middle East and North Africa: Results from the ESMAA study

Tarraf, Hesham; Al‐Jahdali, Hamdan; Qaseer, Abdul Hameed Al; Gjurovic, Anamarija; Haouichat, H.; Khassawneh, Basheer; Mahboub, Bassam; Roozbeh, Nasibeh; Montestruc, François; Behbehani, Nasser

doi:10.1016/j.rmed.2018.03.024

Cited by 48 publications

(48 citation statements)

References 28 publications

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“…This may provide possible explanation as to why ICS/LABA FDC is the choice of many treating physicians within the region. The use of ICS/LABA in these countries has been reported to range from 73.1% in the UAE to 83.7% in Qatar, with a similar proportion reported in Saudi Arabia (76.3%) and Kuwait (76.8%) [5]. These estimates include instances in which ICS/LABA FDC is either used as the main asthma treatment or in combination with other therapies.…”

Section: Introductionmentioning

confidence: 93%

“…Difference was seen in the recurrence of socioeconomic status cluster as being associated with asthma control in adults [6] compared to paediatric population [2]. Similarly, factors cluster of patient care was more recurrent in studies conducted in the adult patient population [5] compared to the paediatric asthma population [2]. Furthermore, adherence to asthma treatment was more often associated with asthma control in adult patients [4] than in paediatric patients [1].…”

Section: Cluster Analysismentioning

confidence: 99%

“…The extent to which the effects of asthma can be seen in individual patients, or reduced by pharmacological or non-pharmacological interventions is known as asthma control [4]. The Epidemiological Study on the Management of Asthma in Asthmatic Middle East Adult Population (ESMAA) re-affirmed the low levels of asthma control in the GCC countries, with the highest levels reported as 41% and 42.6% in Qatar and Kuwait respectively [5].…”

Section: Introductionmentioning

confidence: 99%

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Asthma control factors in the Gulf Cooperation Council (GCC) countries and the effectiveness of ICS/LABA fixed dose combinations: a dual rapid literature review

Noibi¹,

Mohy²,

Gouhar³

et al. 2020

BMC Public Health

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Background: Asthma control is influenced by multiple factors. These factors must be considered when appraising asthma interventions and their effectiveness in the Gulf Cooperation Council (GCC) countries (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and United Arab Emirates [UAE]). Based on published studies, the most prevalent asthma treatment in these countries are fixed dose combinations (FDC) of inhaled corticosteroid and long-acting betaagonist (ICS/LABA). This study is a rapid review of the literature on: (a) factors associated with asthma control in the GCC countries and (b) generalisability of ICS/LABA FDC effectiveness studies. Methods: To review local factors associated with asthma control and, generalisability of published ICS/LABA FDC studies, two rapid reviews were conducted. Review 1 targeted literature pertaining to asthma control factors in GCC countries. Eligible studies were appraised, and clustering methodology used to summarise factors. Review 2 assessed ICS/LABA FDC studies in conditions close to actual clinical practice (i.e. effectiveness studies). Eligibility was determined by reviewing study characteristics. Evaluation of studies focused on randomised controlled trials (RCTs). In both reviews, initial (January 2018) and updated (November 2019) searches were conducted in EMBASE and PubMed databases. Eligible studies were appraised using the Critical Appraisal Skills Program (CASP) checklists. Results: We identified 51 publications reporting factors associated with asthma control. These publications reported studies conducted in Saudi Arabia (35), Qatar (5), Kuwait (5), UAE (3), Oman (1) and multiple countries (2). The most common factors associated with asthma control were: asthma-related education (13 articles), demographics (11articles), comorbidities (11 articles) and environmental exposures (11 articles). Review 2 identified 61 articles reporting ICS/LABA FDC effectiveness studies from countries outside of the GCC. Of these, six RCTs were critically appraised. The adequacy of RCTs in informing clinical practice varied when appraised against previously published criteria.

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Section: Introductionmentioning

confidence: 93%

Section: Cluster Analysismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Asthma control factors in the Gulf Cooperation Council (GCC) countries and the effectiveness of ICS/LABA fixed dose combinations: a dual rapid literature review

Noibi¹,

Mohy²,

Gouhar³

et al. 2020

BMC Public Health

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“…On the other hand, controller medications include inhaled corticosteroids, leukotriene modifiers, and long-acting β-2 adrenoceptor agonists (LABAs). The cost of several asthma medications comprise a substantial proportion of asthma expenditure and, despite the availability of many therapeutically-effective medications, poor adherence and subsequent poor asthma control are considered serious global health problems 8. Uncontrolled asthmatic patients, in spite of proper asthma management plans, require detailed investigation rather than simply escalating their medications’ regimen.…”

Section: Introductionmentioning

confidence: 99%

<p>Association of genetic variants with level of asthma control in the Arab population</p>

Almomani¹,

AL-Eitan²,

Al‐Sawalha³

et al. 2019

JAA

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BackgroundRates of asthma in Jordan have been doubled in the past decade, but this increased prevalence was not met with improved asthma control protocols. The aim of the present study was to assess whether there was any significant association between the level of asthma control and certain single-nucleotide polymorphisms (SNPs) in five genes: (ADRB2; rs1042713 and rs1042714), (CRHR1; rs1876828, rs242939, and rs242941), (STIP1; rs2236647), (ADH5, rs1154400), and (ARG1; rs2781659). These SNPs were selected based on their involvement in enzymes and receptors that are related to asthma pathways and subsequent response to medication and based on a high degree of linkage disequilibrium.Patients and methodsA cross-sectional genetic association study was conducted from June 2016 to June 2017 in the two major hospitals in Jordan. The present study involved sampling from adult asthmatic patients of Arab descent who were selected from two phenotypic groups, ie, controlled and uncontrolled asthma. The blood samples and medical data were collected from the participants. DNA samples were extracted, quantified, and genotyped according to standard operating procedure. Allelic and haplotypic analyses were performed using the Haploview®.ResultsA total of 245 Arab asthmatic patients were enrolled in this study. Genotyping analysis revealed that the two SNPs (rs1042713 and rs1042714) in ADRB2 gene, along with their related haplotypes, were nominally significantly associated with asthma control in the Jordanian population. The A-allele of rs1042713 and the C-allele of rs1042714 were more common in the uncontrolled asthma group than in the controlled asthma group (P=0.048 and P=0.017, respectively).ConclusionThis was the first study that identified the nominal significant association between the level of asthma control and genetic variants in ADRB2 gene in Arab population. Further studies in other Arab region with larger sample size are recommended to confirm the relationship.

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“…The study recommended using decision support tools’ interventions which is defined as health information technology and/or paper-based interventions designed to support/facilitate healthcare provider decision-making, feedback, and audit interventions providing performance data to healthcare providers about their quality of care, and clinical pharmacy support interventions target pharmacists’ delivery of care. In spite of many challenges reported by investigators[ 29 30 31 32 33 ] for using and application of the guidelines such as lack of knowledge and need for further training to manage and prevent asthma, there is a noticeable positive attitude toward applying the guidelines and using it to promote asthma management and control.…”

Section: Discussionmentioning

confidence: 99%

Determinants of family medicine physicians' knowledge and application of asthma management guidelines at primary healthcare centers in Riyadh, Saudi Arabia

Alrabiah

Elsaid

Tourkmani

2018

J Family Med Prim Care

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Asthma control in adults in the Middle East and North Africa: Results from the ESMAA study

Cited by 48 publications

References 28 publications

Asthma control factors in the Gulf Cooperation Council (GCC) countries and the effectiveness of ICS/LABA fixed dose combinations: a dual rapid literature review

Asthma control factors in the Gulf Cooperation Council (GCC) countries and the effectiveness of ICS/LABA fixed dose combinations: a dual rapid literature review

<p>Association of genetic variants with level of asthma control in the Arab population</p>

Determinants of family medicine physicians' knowledge and application of asthma management guidelines at primary healthcare centers in Riyadh, Saudi Arabia

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