Direct costs of asthma in Brazil: a comparison between controlled and uncontrolled asthmatic patients

Santos, Lucia Ande; Oliveira, de; Faresin, Sônia Maria; Santoro, Ilka Lopes; Fernandes, A. L. G.

doi:10.1590/s0100-879x2006005000129

Cited by 28 publications

(28 citation statements)

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“…A recent study has demonstrated that subjects with uncontrolled asthma use more health resources than do those with controlled asthma. (20) In the present study, school absenteeism was higher among the patients with uncontrolled or partially controlled asthma (36.3% and 46.7%, respectively) than among those with controlled asthma (16.2%); however, these values are lower than that found in the AIRLA survey, in which 58% of the children interviewed reported having missed school because of an asthma attack. (7) Asthma symptoms can affect activities of daily living, as well as contributing to school absenteeism.…”

Section: Discussioncontrasting

confidence: 73%

Level of asthma control and its impact on activities of daily living in asthma patients in Brazil

et al. 2013

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Objective: To evaluate the impact of asthma on activities of daily living and on health status in patients with controlled, partially controlled, or uncontrolled asthma in Brazil. Methods: We used data related to 400 patients in four Brazilian cities (São Paulo, Rio de Janeiro, Salvador, and Curitiba), obtained in a survey conducted throughout Latin America in 2011. All study subjects were > 12 years of age and completed a standardized questionnaire in face-to-face interviews. The questions addressed asthma control, hospitalizations, emergency room visits, and school/work absenteeism, as well as the impact of asthma on the quality of life, sleep, and leisure. The level of asthma control was determined in accordance with the Global Initiative for Asthma criteria. Results: Among the 400 respondents, asthma was controlled in 37 (9.3%), partially controlled in 226 (56.5%), and uncontrolled in 137 (34.2%). The numbers of patients with uncontrolled or partially controlled asthma who visited the emergency room, who were hospitalized, and who missed school/work were higher than were those of patients with controlled asthma (p = 0.001, p = 0.05, and p = 0.01, respectively). Among those with uncontrolled asthma, the impact of the disease on activities of daily living, sleep, social activities, and normal physical exertion was greater than it was among those with controlled or partially controlled asthma (p < 0.001). Conclusions:In Brazil, asthma treatment should be monitored more closely in order to increase treatment adherence and, consequently, the level of asthma control, which can improve patient quality of life and minimize the negative impact of the disease.Keywords: Asthma/epidemiology; Quality of life; Hospitalization. ResumoObjetivo: Avaliar o impacto da asma nas atividades da vida diária e na saúde em pacientes com asma controlada, parcialmente controlada ou não controlada no Brasil. Métodos: Foram utilizados dados de 400 pacientes de quatro cidades brasileiras (São Paulo, Rio de Janeiro, Curitiba e Salvador) obtidos em um inquérito realizado em países da América Latina em 2011. Todos os indivíduos do estudo tinham idade > 12 anos e responderam a um questionário padronizado por meio de entrevista presencial. As questões abordavam o controle da asma, número de hospitalizações, de consultas de urgência, absenteísmo na escola/trabalho e impacto da asma na qualidade de vida, sono e lazer. O nível de controle da asma foi verificado segundo os critérios da Global Initiative for Asthma.Resultados: Entre 400 entrevistados, a asma estava controlada em 37 (9,3%); parcialmente controlada, em 226 (56,5%); e não controlada, em 137 (34,2%). O número de pacientes com asma não controlada ou parcialmente controlada que apresentaram hospitalizações, visitas ao pronto-socorro e faltas na escola/trabalho foi maior do que o daqueles com asma controlada (p = 0,001, p = 0,05 e p = 0,01, respectivamente). Os participantes com asma não controlada apresentaram um maior impacto da doença em atividades da vida diária, sono, ativida...

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Section: Discussioncontrasting

confidence: 73%

Level of asthma control and its impact on activities of daily living in asthma patients in Brazil

et al. 2013

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“…In a study with 90 participants that compared the direct costs of treating patients with controlled and uncontrolled asthma (45 per group) in a Brazilian tertiary health care unit, the mean age was similar to the age of our population, but the average monthly family income was lower [15]. Thirty-one patients had mild asthma (34.4%), 41 had moderate asthma (45.5%), and 18 (20.0%) had severe asthma: compared with our population, a slightly higher proportion of patients had severe asthma and a slightly lower proportion had mild asthma in that unit.…”

Section: Resultsmentioning

confidence: 99%

Asthma and the socio-economic reality in Brazil

Costa¹,

Bregman²,

Araújo³

et al. 2013

World Allergy Organization Journal

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BackgroundAsthma is a prevalent disease that is considered a health problem worldwide. The aim of this study was to analyze the clinical and socioeconomic characteristics of a cohort of asthmatics receiving specialized outpatient treatment in a tertiary/teaching public hospital in Brazil.MethodsPersistent asthmatics older than 5 years old were consecutively included. They received clinical treatment at 3- to 4-month intervals and were interviewed 2 times at 6-month intervals over a 12-month observation period. The data were collected directly from the patients or their parents by 2 researchers who did not participate in their clinical care. The primary variables were age, gender, education level, monthly family income, place of residence, number of lost days of school or work, BMI, the severity and control level of asthma, the number of scheduled and non-scheduled visits and hospitalization days and the best peak-flow measurement.ResultsOf the 117 participants, 108 completed the study. Of the participants, 73.8% were women, and 25.0% lived outside the county. Of those who lived within the county, 60.1% lived in areas far from the health care unit. The majority (83.3%) had associated rhinitis, and more than 50.0% were overweight or obese, in whom the prevalence of severe asthma was greater (p = 0.001). The median monthly income was US$ 536.58 and was greater among the patients with controlled asthma (p = 0.005 and p = 0.01 at the start and the end of the study, respectively). In the initial evaluation, 16 participants had severe asthma, and in the final evaluation, 8 out of 21 patients with uncontrolled asthma had improved. Three-quarters of the students and half of the workers had missed days of school or work, respectively. The asthmatic population in this study had medium to low socioeconomic status in Brazil and socioeconomic status was associated with overweigth/obesity and with poor control of asthma.ConclusionAsthma has a great impact on absenteeism in Brazil. Lower monthly family income and body weight above the ideal level were associated with greater severity and worse control of asthma.

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“…Asthma is a highly prevalent chronic disease that affects individuals of all ages, representing an important cause of morbidity and, consequently, direct and indirect healthcare expenditures. [1][2][3][4][5] The southern region of Brazil, characterized by a humid subtropical climate with well-defined seasons, moderately cold winters and hot summers, 6 presents the highest prevalence of diagnosis for this condition, estimated at 5.3% of adults. 7 Among elementary school students, the prevalence of clinical symptoms has been estimated at 23.6%.…”

Section: Introductionmentioning

confidence: 99%

Distance Education to Improve the Quality of Asthma Treatment in Primary Health Care

Roman

Lima

Moreira

et al. 2019

Rev Bras Med Fam Comunidade

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Objective: The mere dissemination of standard care recommendations has been insufficient to improve clinical results in patients with asthma. The objective of the present study was to evaluate the clinical effectiveness of a multifaceted asthma distance education for primary care providers. Methods: Cluster randomized controlled trial. Full primary care teams were included if they had access to telehealth support and free basic asthma treatment. Before randomization, selected teams indicated asthma patients between 5-45 years old for inclusion. The intervention group received three interactive online sessions, printed educational material, reminders, booklet for patients, and frequent stimulus to use consulting services. The control group received no intervention. Symptomfree days per two weeks was the primary result. Controlled asthma, unscheduled asthma doctor visits, and preventive inhaled corticosteroid use were the secondary results. Six months after intervention, the results were compared with baseline data using generalized estimating equations for repeated measures and clustering effect. Results: Were enrolled 71 primary care teams and 443 individuals. Most patients (60.3%) were female, and 44% were younger than 12 years old. The attendance of interactive sessions by the teams was 50%. The odds ratio (OR) for additional symptom-free day was 1.31 (95%CI 0.61-2.82; p=0.49). For the secondary results, the results were: controlled asthma OR 1.29 (95%CI 0.89-1.87; p=0.18); unscheduled asthma doctor visits OR 0.81 (95%CI 0.60-1.10; p=0.17); and preventive inhaled corticosteroid use OR 1.02 (95%CI 0.71-1.47; p=0.91). Conclusions: Multifaceted distance education in asthma care for primary care providers was not effective to improve patients’ results. Telemedicine needs to deal with significant obstacles in professional education. ClinicalTrials.gov registry: NCT01595971.

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Direct costs of asthma in Brazil: a comparison between controlled and uncontrolled asthmatic patients

Cited by 28 publications

References 19 publications

Level of asthma control and its impact on activities of daily living in asthma patients in Brazil

Level of asthma control and its impact on activities of daily living in asthma patients in Brazil

Asthma and the socio-economic reality in Brazil

Distance Education to Improve the Quality of Asthma Treatment in Primary Health Care

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