Comparison of Asthma Control Criteria: Importance of Spirometry

Dostaler, Suzanne M.; Olajos-Clow, Jennifer; Sands, Todd W.; Licskai, Christopher; Minard, Janice P.; Lougheed, M. Diane

doi:10.3109/02770903.2011.631243

Cited by 15 publications

(13 citation statements)

References 36 publications

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“…41 A study in primary care from Canada showed the importance of using a spirometer as part of the control index for patients from 6 years of age. 42 In the present study, only a minority of the children older than 6 years of age had ever undergone a spirometry test even though all the PHCs had access to a spirometer.…”

Section: Interpretation Of Findings In Relation To Previously Publishmentioning

confidence: 62%

Adherence to national guidelines for children with asthma at primary health centres in Sweden: potential for improvement

Jonsson

Egmar

Kiessling

et al. 2012

Primary Care Respiratory Journal

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Section: Interpretation Of Findings In Relation To Previously Publishmentioning

confidence: 62%

Adherence to national guidelines for children with asthma at primary health centres in Sweden: potential for improvement

Jonsson

Egmar

Kiessling

et al. 2012

Primary Care Respiratory Journal

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“…The Expert Panel Report 3 (EPR-3) recommends the use of spirometry in the diagnosis and periodic monitoring of patients with asthma [11]. The use of symptoms alone has been shown to underrepresent the degree of asthma severity [26]. Symptoms are fairly reliable indexes of asthma control; however, symptoms and lung function do not always correlate.…”

Section: Discussionmentioning

confidence: 99%

Loss of Asthma Control in Pediatric Patients after Discontinuation of Long-Acting Beta-Agonists

2012

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Recent asthma recommendations advocate the use of long-acting beta-agonists (LABAs) in uncontrolled asthma, but also stress the importance of stepping down this therapy once asthma control has been achieved. The objective of this study was to evaluate downtitration of LABA therapy in pediatric patients who are well-controlled on combination-inhaled corticosteroid (ICS)/LABA therapy. Clinical and physiologic outcomes were studied in children with moderate-to-severe persistent asthma after switching from combination (ICS/LABA) to monotherapy with ICS. Of the 54 patients, 34 (63%) were determined to have stable asthma after the switch, with a mean followup of 10.7 weeks. Twenty (37%) had loss of asthma control leading to addition of leukotriene receptor antagonists, increased ICS, or restarting LABA. There were 2 exacerbations requiring treatment with systemic steroids. In patients with loss of control, there was a statistically significant decline in FEV1 (−8% versus −1.9%, P = 0.03) and asthma control test (−3.2 versus −0.5, P = 0.03). This did not approach significance for FEF25-75%, exhaled nitric oxide, lung volumes or airway reactivity. No demographic, asthma control measures, or lung function variables predicted loss of control. Pediatric patients with moderate-to-severe persistent asthma who discontinue LABA therapy have a 37% chance of losing asthma control resulting in augmented maintenance therapies. Recent recommendations of discontinuing LABA therapy as soon as control is achieved should be evaluated in a prospective long-term study.

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“…The GINA classification is perhaps the most widely recognised and recommended asthma assessment tool worldwide [ 11 ]. Although the GINA classification has not been formally validated, recent studies have demonstrated different degrees of agreement between it and other tools [ 24 - 26 ]. When Rodrigo et al [ 25 ] tested the Spanish version of the ACT, they observed that the instrument had a weak correlation with FEV 1 and that almost 40% of patients with a predicted FEV 1 less than 60% had considered his illness totally controlled, concluding that the ACT is not an appropriate tool to guide asthma management if used without spirometry.…”

Section: Discussionmentioning

confidence: 99%

Central obesity and other factors associated with uncontrolled asthma in women

Capelo

Fonseca

Peixoto

et al. 2015

All Asth Clin Immun

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BackgroundAsthma remains an uncontrolled disease. The Comorbidities, particularly obesity, and several other factors have been identified as being individually associated with asthma control, and these factors vary among different countries and between sexes. Studies have suggested that the harmful effects of these factors are greatest among women. The aim of the present study was to identify associated factors with uncontrolled asthma in women at the outpatient clinic of a Federal University Hospital in Rio de Janeiro, Brazil.MethodsCross-sectional study with asthmatic women, older than 18 years old. All subjects were included according to stringent criteria. The study used a structured questionnaire with data about demographic variables, education level, comorbid conditions, and disease history. Anthropometric and spirometric measurements were obtained. Asthma control was assessed by three different tools: the Asthma Control Test (ACT), the Asthma Control Questionnaire (ACQ) and the Global Initiative for Asthma (GINA) criteria.ResultsA total of 124 women were included, and 57%, 38% and 21% were totally controlled according to ACT, ACQ and GINA criteria, respectively. A total of 31.5% were obese. According to the CI (Conicity Index) and WC (waist circumference) respectively, 84% and 68% were centrally obese. There was no association between asthma control and age, education, duration of the disease or BMI (Body Mass Index) in the three models, but there was a significant association between central obesity and asthma control with the ACQ and GINA assessment tools, controlling for explanatory variables such as GERD (gastroesophageal reflux disease). Pre-bronchodilator percent predicted forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) were significantly associated with age and FVC was also associated with central obesity.ConclusionsAsthma remains uncontrolled in women despite treatment, and central obesity seems to have a negative influence on the control of the disease. We believe that women should be studied as a separate group and suggest prospective studies with assessment of fat distribution and biomarkers, controlling for possible comorbidities associated with asthma control.

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Comparison of Asthma Control Criteria: Importance of Spirometry

Cited by 15 publications

References 36 publications

Adherence to national guidelines for children with asthma at primary health centres in Sweden: potential for improvement

Adherence to national guidelines for children with asthma at primary health centres in Sweden: potential for improvement

Loss of Asthma Control in Pediatric Patients after Discontinuation of Long-Acting Beta-Agonists

Central obesity and other factors associated with uncontrolled asthma in women

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