Asthma Control and Management Changes in Japan: Questionnaire Survey

Abstract

Background Despite the advances of asthma management and the accompanying improved asthma control, many problems related to asthma management still remain. The Niigata Asthma Treatment Study Group has been regularly collecting information via surveys since 1998 using a questionnaire, on problems related to asthma management; various studies on asthma management have been reported using data from the questionnaire. Methods The aim of this study was to investigate the changes in asthma control and management for every two-year period using the data from 1998 to 2008; future problems requiring resolution were extracted and discussed. Results The number of cases surveyed each year was about 3,000 (2,593-3,347 cases). The changes in the data from 1998 to 2008, including asthma attacks and symptoms rate, indicated the improvement of asthma control with the spread of medication according to the guidelines; of particular note, there was a 24.1% increase in the usage rate of inhaled corticosteroids during the study period. From 2002 to 2008, however, some asthmatic conditions seemed to show no improvement with regards to asthma control related to the rates of changes in peak flow meter use, leukotriene receptor antagonist use and oral sustained-released theophylline use. Moreover, there was no decrease in the occurrence of emergency episodes related to asthma deaths. Conclusion In the actual clinical setting, asthma control seems to be progressing well with the appropriate changes of medication according to the guidelines, and in part due to inhaled corticosteroid use. However, there were two problems which need to be addressed: 1) no improvement in some asthmatic conditions and 2) the occurrence of emergency episodes related to asthma deaths. In the future, it will be necessary to manage asthma in view of these points.

The prevalence and disease burden of severe eosinophilic asthma in Japan

“…Asthma is a heterogeneous chronic inflammatory disorder of the airways that affects over 300 million people worldwide [1][2][3][4], and is associated with airway hyper-responsiveness and variable airflow obstruction [1]. In Japan, approximately 6%-7% of patients with asthma have severe asthma [5,6], which is characterized by frequent exacerbations and poor symptom control, despite the regular intensive use of maintenance therapies such as high-dose inhaled corticosteroids (ICS) or long-acting b 2 -agonists (LABA) and additional controller medications [7]. In severe asthma, these medications are required to either prevent progression to uncontrolled asthma, or where asthma remains uncontrolled despite these clinical interventions [7].…”

The effects of concomitant GERD, dyspepsia, and rhinosinusitis on asthma symptoms and FeNO in asthmatic patients taking controller medications

“…Guideline-based management results in significant improvement in health-related quality of life in most patients 1. Although the goal of therapy is to control asthma by reducing impairment and risk, many patients seem to continue to have some asthma symptoms, such as cough, phlegm, or dyspnea, when asked about their symptoms on a questionnaire 2. Some important complications that occur with asthma, such as rhinitis,3 sinusitis,4,5 and gastroesophageal reflux disease (GERD),6 are known to affect asthma symptoms.…”

Methylxanthine use for acute asthma in the emergency department in Japan: a multicenter observational study

“…In this context, recent studies have also reported decreases in methylxanthine use for ED patients with acute asthma in other developed nations . Furthermore, similar practice changes have been reported in the primary care setting in Japan . Nevertheless, despite the clinical importance, there has been no study that investigates the current methylxanthine use for acute asthma in Japanese EDs.…”