Repeated cross-sectional survey of patient-reported asthma control in Europe in the past 5 years

Abstract

Although the main goal of asthma management guidelines is to achieve and maintain clinical control, reported levels of not well-controlled asthma remain high. The aim of this analysis was to compare the levels of asthma control and the associated impact on patients' health status in Europe in 2006, 2008 and 2010. An additional outcome was the comparison of the burden of asthma with diabetes. Data were obtained from the cross-sectional, self-reported, European National Health and Wellness Surveys conducted in France, Germany, Italy, Spain and the UK. Asthma control (Asthma Control Test™; QualityMetric, Inc., Lincoln, RI, USA) and health status (Short Form (SF)-12 health survey and the Work Productivity Loss and Activity Impairment questionnaire) were assessed. In 2010, the proportion of treated asthma patients assessed as having not well-controlled asthma was 53.5%, compared with 56.6% and 55.0% in 2008 and 2006, respectively. A significant reduction in not well-controlled asthma was observed in Germany between 2006 (72.3%) and 2010 (62.5%; p=0.005). Fluctuations in control levels were observed in other countries. For all surveys, having at least well-controlled asthma was associated with a significantly lower number of healthcare contacts in the previous 6 months, better mean±(SD) SF-12 scores for the physical (data for 2010: not well controlled 39.9±11.38, at least well-controlled 48.0±9.89; p<0.001) and mental (data for 2010: not well-controlled 40.6±10.95, at least well-controlled 45.0±10.91; p<0.001) components, and significantly less impact on Work Productivity Loss and Activity Impairment. Asthma and diabetes were associated with a similar overall negative impact on health status. A substantial proportion of asthmatics remain not well-controlled across five European countries, resulting in a significant impact on health resources and patients' health status. The overall burden of asthma appears to be similar to that of diabetes.

The Life's Limitations of Uncontrolled Asthma in a Developing Country: Results of an Albanian Survey

“…The general attitude of Albanian asthmatics shows a similarity towards Europeans with severe BA in the industrialized countries [2][3][4][5][6][7][8][9][10][11]. These findings suggest that in our country patients with uncontrolled asthma represent the majority, and that Albanian (predominantly male) patients consider their BA as a disease only if they experience uncontrolled symptoms and daily restrictions.…”

“…This demonstrate that a substantial proportion of asthmatics remain not well-controlled [8]. In 2010, the proportion of treated asthma patients assessed as having not well-controlled asthma was about 54%, compared to 57% and 55% in 2008 and 2006, respectively [2,8].…”

“…BA is controllable when patients adhere to the correct treatment according to respective management guidelines [3][4][5]. In industrialized countries, severe persistent BA is associated with a particularly high exacerbation's risk, Most surveys across Europe provide data from industrialized or advanced developing countries, but there is a lack of published data from countries with poor socio-economical situation of the same regional and ethnic populations [2,5,[7][8][9][10][11]. We report about the outcomes of an Albanian survey, focused on the opinions of subjects with uncontrolled BA, providing also insight into the level of their lives affection.…”

Management of asthma in Benin: the challenge of loss to follow-up

“…1 The International Study of Asthma and Allergies in Childhood (ISAAC) reported that there was a high proportion of children with asthma symptoms in several low-and middlei ncome countries, and that the prevalence of asthma is increasing in some of these countries. 1,2 Unfortunately, management of asthma is suboptimal for a substantial proportion of asthma patients worldwide, [3][4][5] and most have limited access to affordable inhaled corticosteroids. [6][7][8] A comprehensive lung health project funded by the World Bank and implemented through collaboration between the International Union Against Tuberculosis and Lung Disease (The Union) and partners in Benin, China and Sudan, included as one of its aims to reduce the burden of lung disease through improvement of case management of patients with persistent asthma.…”

Fluticasone propionate/formoterol: A fixed-combination therapy with flexible dosage

“…The economic burden in terms of direct (hospitalization, use of emergency room visits, therapy) and indirect (missed days of work/school) costs adds to the emotional, physical and social impact of asthma, with consequent quality of life deterioration for both patients and their families [3]. Despite the availability of effective treatments, a large proportion of asthma patients experience symptoms of uncontrolled asthma, even in those geographical areas where good standards of care are available [2,[4][5][6][7][8].…”