A 10 year asthma programme in Finland: major change for the better

Haahtela, Tari; Tuomisto, Leena E.; Pietinalho, Anne; Klaukka, Timo; Erhola, Marina; Kaila, Minna; Nieminen, Markku M.; Kontula, Eva; Laitinen, Lauri A.

doi:10.1136/thx.2005.055699

Cited by 382 publications

(444 citation statements)

References 23 publications

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“…The programme focused on early diagnosis, active antiinflammatory treatment from the outset, guided self-management and effective networking with the GPs and pharmacists. The results did not leave much to argue (17,18). Even though the programme was not able to halt the still ongoing rise of asthma occurrence, it reduced markedly mortality, hospital days and disability.…”

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confidence: 72%

Reduction of asthma burden is possible through National Asthma Plans

Kupczyk

Haahtela

Cruz

et al. 2010

Allergy

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To cite this article: Kupczyk M, Haahtela T, Cruz AA, Kuna P. Reduction of asthma burden is possible through National Asthma. Allergy 2010; 65: 415–419.AbstractDespite increase in understanding of asthma patomechanisms the practical actions to lessen asthma burden in the communities are far behind of scientific knowledge. There are still reports of uderdiagnosis and poor treatment leading to repeated severe exacerbations, often demanding emergency care and hospitalisation, which cause most of the economic burden both for families and society. From the public health perspective, the key issue is to implement the best standards of care in every‐day practice. The problems are different in high income compared to low‐ and middle‐income countries, and the solutions have to be tailored to each country needs and resources. We present here examples from Finland, Poland and Brazil, to show that asthma burden can be reduced using varied strategies in quite different societal, economical and health care environments. The experience from those interventions confirms that regardless of the health care system and its coverage, a major change for the better can be achieved by local efforts, systematic planning and networking to implement the best asthma practice.

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confidence: 72%

Reduction of asthma burden is possible through National Asthma Plans

Kupczyk

Haahtela

Cruz

et al. 2010

Allergy

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“…Smokers (current or ex-) and patients with co-morbidities were included in the study. The patients were treated and monitored according to Finnish Asthma Program guidelines [19] either in the specialized care or in primary care. The collection of research data has been previously reported [7,9,10,20].…”

Section: Methodsmentioning

confidence: 99%

Daily physical activity and lung function decline in adult-onset asthma: a 12-year follow-up study

Loponen

Ilmarinen

Tuomisto

et al. 2018

European Clinical Respiratory Journal

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Background: There is a lack of knowledge on the association between daily physical activity and lung function in patients with asthma. Objective: This study aims to examine the association between daily physical activity and asthma control, lung function, and lung function decline in patients with adult-onset asthma. Design: This study is part of Seinäjoki Adult Asthma Study (SAAS), where 201 patients were followed for 12 years after asthma diagnosis. Daily physical activity was assessed at follow-up by a structured questionnaire and used to classify the population into subgroups of low (≤240 min) or high (>240 min) physical activity. Three spirometry evaluation points were used: 1. diagnosis, 2. the maximum lung function during the first 2.5 years after diagnosis (Max0-2.5), 3. follow-up at 12 years. Results: High physical activity group had slower annual FEV1 (p<0.001) and FVC (p<0.018) decline. Additionally, the high physical activity group had higher FEV1 values at follow-up, and higher FEV1/FVC ratios at follow-up and diagnosis. There was no difference in BMI, smoking, medication, or frequency of physical exercise between high and low physical activity groups. Differences remained significant after adjustments for possible confounding factors. Conclusion: This is the first demonstration of an association between long-term FEV1 decline and daily physical activity in clinical asthma. Low physical activity is independently associated with faster decline in lung function. Daily physical activity should be recommended in treatment guidelines in asthma.

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“…(7,12) Education programs on asthma associated to medication represent one of the pillars of the success of the effectiveness of the asthma program and have been proven to reduce exacerbations and hospitalizations for asthma, as well as reducing the expenses with the disease. (13) The Programa de Controle da Asma e Rinite Alérgica em Feira de Santana (ProAR-FS, Program for the Control of Asthma and Allergic Rhinitis in the city of Feira de Santana, Brazil) was evaluated using data from the Information Technology Department of the Unified Health Care System after the first year of the program in the city, and a reduction of 42% in hospitalizations for asthma was observed.…”

Section: Introductionmentioning

confidence: 99%

Hospitalizações por asma: impacto de um programa de controle de asma e rinite alérgica em Feira de Santana (BA)

et al. 2009

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Objective: To evaluate the impact of the Programa de Controle da Asma e Rinite Alérgica em Feira de Santana (ProAR-FS, Program for the Control of Asthma and Allergic Rhinitis in Feira de Santana) on the frequency of hospitalizations for asthma in patients monitored at a referral center for one year. Methods: This was a historical control study involving 253 consecutive patients with asthma, ages ranging from 4 to 76 years. We compared the frequency of hospital admissions and visits to the emergency room (ER) in the 12 months prior to and after their admission to the ProAR-FS. During the program, patients received free treatment, including inhaled medications and education on asthma. Demographic and socioeconomic aspects were also assessed. Results: There was a significant reduction in the number of hospitalizations (465 vs. 21) and of visits to the ER (2,473 vs. 184) after their admission to ProAR-FS (p < 0.001 for both). Of the 253 patients who had been hospitalized and had had ER visits within the year prior to the admission to ProAR-FS, only 16 were hospitalized and 92 visited the ER during the follow-up year, representing a reduction of 94% and 64%, respectively. Conclusions: Implementing a referral center for the treatment of asthma and rhinitis in the Unified Health Care System, with the free distribution of inhaled corticosteroids and the support of an education program, is a highly effective strategy for the control of asthma.Keywords: Hospitalization; Asthma; Rhinitis; Health services; Public health. ResumoObjetivo: Avaliar o impacto do Programa de Controle da Asma e Rinite Alérgica em Feira de Santana (ProAR-FS) na frequência de hospitalizações por asma em pacientes acompanhados por um ano em um centro de referência. Métodos: Estudo de controle histórico de 253 pacientes com asma, entre 4 e 76 anos idade, e admitidos consecutivamente. Comparou-se a frequência de internações e de atendimentos em emergência nos doze meses anteriores e posteriores à sua inclusão no ProAR-FS. Durante o programa, os pacientes receberam atendimento gratuito, incluindo medicação inalatória e educação em asma. Os aspectos demográficos e socioeconômicos também foram avaliados. Resultados: Houve redução significativa no número de internações (463 vs. 21) e de atendimentos em emergência (2.473 vs. 184) após a matrícula no ProAR-FS (p < 0,001 para ambos). Dos 253 pacientes internados e atendidos na emergência no ano anterior à participação no ProAR-FS, apenas 16 foram novamente internados e 92 foram atendidos na emergência durante o ano de acompanhamento, correspondendo a uma redução de 94% e 64%, respectivamente. Conclusões: A implementação de um ambulatório de referência para o tratamento de asma e rinite no Sistema Público de Saúde, com o fornecimento de corticoide inalatório e o suporte de um programa de educação, é uma estratégia muito efetiva para o controle da asma.

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A 10 year asthma programme in Finland: major change for the better

Cited by 382 publications

References 23 publications

Reduction of asthma burden is possible through National Asthma Plans

Reduction of asthma burden is possible through National Asthma Plans

Daily physical activity and lung function decline in adult-onset asthma: a 12-year follow-up study

Hospitalizações por asma: impacto de um programa de controle de asma e rinite alérgica em Feira de Santana (BA)

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