Free asthma medications reduces hospital admissions in Brazil (Free asthma drugs reduces hospitalizations in Brazil)

Comaru, Talitha; Pitrez, Paulo Márcio; Friedrich, Frederico; Silveira, Victória D'Azevedo; Pinto, Leonardo Araújo

doi:10.1016/j.rmed.2016.10.008

Cited by 26 publications

(21 citation statements)

References 12 publications

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“…The findings also indicated a significant association between knowledge about medication gratuity and self-efficacy in controlling childhood asthma. There were similar results in a study (24) developed in Brazil that demonstrated a 33.57% decrease in hospitalization rates for asthma with the knowledge and access to free medication by the Popular Pharmacy program (beclomethasone and salbutamol). This represented a saving of 51% in financial expenses of the system with asthma-related hospitalizations.…”

Section: Discussionsupporting

confidence: 75%

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Association of self-efficacy of parents/caregivers with childhood asthma control parameters

Gomes

Lima

Mendes

et al. 2018

Rev. esc. enferm. USP

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Objective To verify the association between the self-efficacy of parents/caregivers and control parameters of childhood asthma. Method Cross-sectional study with parents/caregivers of asthmatic children. Data were collected through a sociodemographic questionnaire and the Self-efficacy and their child's level of asthma control scale: Brazilian version. Results Participation of 216 parents/caregivers in the study. There was a statistically significant association between self-efficacy scores and the following variables: unscheduled physician visit (p=0.001), visit to emergency department (p<0.001), hospital stays in the previous 12 months (p=0.005), physical activity limitation (p=0.003), school days missed (p<0.001), impaired sleep (p<0.001), ability to differentiate crisis medication from control medication (p=0.024), use of spacer (p=0.001), performing oral hygiene after use of inhaled corticosteroids (p=0.003), and knowledge of medication gratuity (p=0.004). Conclusion A significant relationship of the self-efficacy of parents/caregivers of asthmatic children with control parameters and training on the necessary skills to reach this control was demonstrated in the study.

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Section: Discussionsupporting

confidence: 75%

“…The maximization of access to medication with guarantees of use according to an action plan associated to an adequate technique for use of inhalation devices is a primordial factor in the management of asthma exacerbations and prevention of severe episodes of the disease (24)(25) .…”

Section: Discussionmentioning

confidence: 99%

Association of self-efficacy of parents/caregivers with childhood asthma control parameters

Gomes

Lima

Mendes

et al. 2018

Rev. esc. enferm. USP

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“…The lack of use of recommended asthma medications, particularly ICS in this cohort, calls for efforts to increase availability and affordability of asthma medication. Increased access to medicines has been reported to result in better asthma treatment outcomes in some settings, such as the case of Brazil where hospitalisations were significantly reduced with increased access to medications 10. In conclusion, the rates of asthma exacerbations and mortality observed in this study are very high and require strengthening of the health systems to improve asthma care in Uganda.…”

Section: Discussionmentioning

confidence: 60%

Rates of asthma exacerbations and mortality and associated factors in Uganda: a 2-year prospective cohort study

Kirenga

Jong

Mugenyi

et al. 2018

Thorax

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Data on asthma treatment outcomes in Africa are limited. 449 patients with asthma (age 5-93 years) in Uganda were followed up for 2 years to determine rates of exacerbations and mortality and associated factors. During follow-up the median number of exacerbations per patient was 1 (IQR 0-5) and 17 patients died (3.7%, 27.3 deaths per 1000 person years). Considering only the first year of follow-up, 59.6% of the patients experienced at least one exacerbation, 32.4% experienced three or more exacerbations. A multivariable model showed that the likelihood of experiencing at least one exacerbation in the first year of follow-up was lower with better baseline asthma control (higher asthma control test (ACT) score), with OR 0.87 (95% CI: 0.82 to 0.93, P=0.000), and was higher with more exacerbations in the year prior to enrolment (OR for log number of exacerbations 1.28, 95% CI: 1.04 to 1.57, P=0.018). Better asthma control (OR 0.93, 95% CI: 0.88 to 0.99, P=0.021) and number of baseline exacerbations (OR 1.35,95% CI: 1.11 to 1.66, P=0.005) were also the only factors that were independently associated with experiencing three or more exacerbations during the first year of follow-up. The only factor found to be associated with all-cause mortality was FEV, with higher recent FEV associated with lower all-cause mortality (OR 0.30, 95% CI: 0.14 to 0.65; P=0.002). Rates of asthma exacerbations and mortality are high in Uganda and are associated with poor asthma control. Health systems should be strengthened to care for asthma patients.

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“… 1 In Brazil, the hospitalization admission rate due to asthma is 59.85 per 100,000 inhabitants (2012–2014), and such patients have a significantly increased risk of respiratory and all-cause mortality. 2 …”

Section: Introductionmentioning

confidence: 99%

Tolerogenic Dendritic Cells Reduce Airway Inflammation in a Model of Dust Mite Triggered Allergic Inflammation

Aragão-França

Rocha

Andrade

et al. 2018

Allergy Asthma Immunol Res

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PurposeThe use of tolerogenic dendritic cells (TolDCs) to control exacerbated immune responses may be a prophylactic and therapeutic option for application in autoimmune and allergic conditions. The objective of this work was to evaluate the effects of TolDC administration in a mouse model of allergic airway inflammation caused by mite extract.MethodsMouse bone marrow-derived TolDCs were induced by incubation with granulocyte-macrophage colony-stimulating factor (GM-CSF) and dexamethasone, and then characterized by flow cytometry and cytokine production by enzyme-linked immunosorbent assay (ELISA). For the in vivo model of Blomia tropicalis-induced allergy, mice transplanted with antigen-pulsed TolDCs were sensitized intraperitoneally with B. tropicalis mite extract (BtE) adsorbed to aluminium hydroxide. After challenge by nasal administration of BtE, bronchoalveolar lavage fluid (BALF), lungs, spleen and serum were collected for analysis.ResultsInduction of TolDCs was efficiently achieved as shown by low expression of major histocompatibility complex (MHC) II, programmed death-ligand (PD-L) 2 and pro-inflammatory cytokine production, and up-regulation of interleukin (IL)-10, upon LPS stimulation in vitro. Transplantation of 1 or 2 doses of BtE-pulsed TolDCs reduced the number of inflammatory cells in BALF and lungs as well as mucus deposition. Moreover, compared to saline-injected controls, TolDC-treated mice showed lower serum levels of anti-BtE immunoglobulin E (IgE) antibodies as well as reduced Gata3 and IL-4 gene expression in the lungs and decreased IFN-γ levels in the supernatant of splenocyte cultures Transplantation of TolDCs increased the percentage of the regulatory T cells in the spleen and the lungs.ConclusionsPreventive treatment with TolDCs protects against dust mite-induced allergy in a mouse model, reinforcing the use of tolerogenic dendritic cells for the management of allergic conditions.

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Free asthma medications reduces hospital admissions in Brazil (Free asthma drugs reduces hospitalizations in Brazil)

Abstract: Asthma hospitalization rates significantly decreased in the three-year period after the provision of free medicines to treat asthma. Our findings suggest that the provision of free medications for asthma may have a particular public health impact by its own in developing countries.

Cited by 26 publications

References 12 publications

Association of self-efficacy of parents/caregivers with childhood asthma control parameters

Association of self-efficacy of parents/caregivers with childhood asthma control parameters

Rates of asthma exacerbations and mortality and associated factors in Uganda: a 2-year prospective cohort study

Tolerogenic Dendritic Cells Reduce Airway Inflammation in a Model of Dust Mite Triggered Allergic Inflammation

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