Lack of Correlation of Symptoms With Specialist-Assessed Long-term Asthma Severity

Osborne, Molly L.; Vollmer, William M.; Pedula, Kathryn L.; Wilkins, J. H.; Buist, A. Sonia; O’Hollaren, Mark T.

doi:10.1378/chest.115.1.85

Cited by 81 publications

(43 citation statements)

References 19 publications

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“…The present study demonstrates the importance of incorporating pulmonary function and asthma medication class into assessment of disease severity. These two dimensions have been shown to be better markers for asthma severity than symptom report (33). This point may be particularly salient to asthma-PD patients.…”

Section: Discussionmentioning

confidence: 98%

Health Care Use and Quality of Life Among Patients with Asthma and Panic Disorder

Feldman¹,

Lehrer²,

Borson³

et al. 2005

LJAS

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The purpose of this study was to assess the associations between panic disorder (PD) and health services use, health-related quality of life, and use of short-acting β 2 -agonists among individuals with asthma. We studied 21 adults with comorbid asthma and panic disorder (asthma-PD) and 27 asthma patients without PD (asthma-only). Participants attended a single session at a laboratory to complete the study. A retrospective chart review was conducted to assess use of health care resources for asthma treatment during the past 12 months. Patients completed the Asthma Quality of Life Questionnaire and lung function testing. Asthma-only and asthma-PD patients displayed no differences on asthma severity, as measured by spirometry and asthma medication class. Asthma-PD patients had more visits to their primary care physicians for asthma ( p < 0.01) and reported a lower quality of life related to asthma ( p < 0.01) and greater use of short-acting β 2 -agonists ( p < 0.05) than asthma-only patients. These findings were independent of pulmonary function, asthma medication class, and sociodemographic status. These data show that coexistence of PD in asthma is associated with increased use of primary care health resources and greater perceived impairment from asthma, independent of asthma severity. These findings indicate a need to develop interventions to improve quality of life and self-management of asthma among PD patients.

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Section: Discussionmentioning

confidence: 98%

Health Care Use and Quality of Life Among Patients with Asthma and Panic Disorder

Feldman¹,

Lehrer²,

Borson³

et al. 2005

LJAS

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“…ASTHMA SEVERITY, CONTROL AND PHENOTYPES Several reviews of the relationship between severity and control have been published [4,[13][14][15][16], although, not surprisingly, given the above history, the conclusions vary between authors. Most authors highlighted that the terms severity and control should not be regarded as synonymous, as patients with severe asthma may be well controlled on high doses of treatment and patients with mild asthma may be currently poorly controlled, e.g.…”

Section: Is a Concept Of Asthma Severity Still Needed?mentioning

confidence: 99%

A new perspective on concepts of asthma severity and control

Taylor¹,

Bateman²,

Boulet³

et al. 2008

Eur Respir J

413

321

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Concepts of asthma severity and control are important in the evaluation of patients and their response to treatment but the terminology is not standardised and the terms are often used interchangeably. This review, arising from the work of an American Thoracic Society/European Respiratory Society Task Force, identifies the need for separate concepts of control and severity, describes their evolution in asthma guidelines and provides a framework for understanding the relationship between current concepts of asthma phenotype, severity and control.''Asthma control'' refers to the extent to which the manifestations of asthma have been reduced or removed by treatment. Its assessment should incorporate the dual components of current clinical control (e.g. symptoms, reliever use and lung function) and future risk (e.g. exacerbations and lung function decline).The most clinically useful concept of asthma severity is based on the intensity of treatment required to achieve good asthma control, i.e. severity is assessed during treatment. Severe asthma is defined as the requirement for (not necessarily just prescription or use of) highintensity treatment. Asthma severity may be influenced by the underlying disease activity and by the patient's phenotype, both of which may be further described using pathological and physiological markers. These markers can also act as surrogate measures for future risk.

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“…Asthma severity can be considered as an intrinsic and rather stable characteristic of the disease for a given patient, i.e. the maximal level of impairment that asthma can bring to that patient, up to and including death; it is unclear how severity is affected by therapy [2]. One way to assess severity is the level of corticosteroid prescription, inhaled or oral [3].…”

mentioning

confidence: 99%

Persistent asthma: disease control, resource utilisation and direct costs

Ganse

Laforest²,

Pietri³

et al. 2002

Eur Respir J

121

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Despite evidence that adverse outcomes are less frequent when asthma management is optimised, the link between the level of control, disease severity and medical resource utilisation (MRU) is poorly documented. This relationship was investigated in a group of patients suffering from persistent asthma (Global Initiative for Asthma (GINA) o2) in France.In 1998 a computerised family practice database was used to identify asthma patients aged 17-50 yrs. Information from the database was complemented by a patient survey to retrospectively assess the level of asthma control and hospital contacts. Costs of MRU over a 12-month study period were related to demographics, medical history, asthma control, and doses of inhaled corticosteroids prescribed during the prestudy period.A review of the computerised medical database identified 1,038 adult patients with persistent asthma, who completed the survey questionnaire. Over a 12-month period, the mean cost of MRU was 549.8 J for well-controlled patients, 746.3 J per patient with moderate control, and 1,451.3 J per patient with poor control. Costs also increased significantly with age, access to free asthma care, comorbid conditions, asthma symptoms in the past year and whether inhaled corticosteroids had been prescribed before the study period.In patients with persistent asthma, large differences were observed in the use of medical resources according to control and severity. Therefore, if patients appropriately use prescribed control therapy, their use of medical resources may be reduced. Eur Respir J 2002; 20: 260-267

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Lack of Correlation of Symptoms With Specialist-Assessed Long-term Asthma Severity

Cited by 81 publications

References 19 publications

Health Care Use and Quality of Life Among Patients with Asthma and Panic Disorder

Health Care Use and Quality of Life Among Patients with Asthma and Panic Disorder

A new perspective on concepts of asthma severity and control

Persistent asthma: disease control, resource utilisation and direct costs

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