Practice Patterns for Chronic Respiratory Diseases in the Asia-Pacific Region: A Cross-Sectional Observational Study

Wang, De Yun; Cho, Sang Heon; Lin, Horng Chyuan; Ghoshal, Aloke Gopal; Muttalif, Abdul Razak; Thanaviratananich, Sanguansak; Tunceli, Kaan; Urdaneta, Elena; Zhang, Dongmu; Faruqi, Rab

doi:10.1159/000489015

Cited by 7 publications

(5 citation statements)

References 35 publications

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“…6,7 A cross-sectional observational study conducted in six countries from the Asia-Pacific region demonstrated considerable healthcare resource utilization (HCRU) and associated cost burden owing to chronic respiratory diseases (combined: asthma, allergic rhinitis, chronic obstructive pulmonary disease (COPD), and rhinosinusitis). 8 The socioeconomic burden for asthma, specifically in Asia, consists of individual reports from Thailand, South Korea, Singapore, Taiwan, and India. 9–14 However, data focusing on HCRU in asthma patients from Japan are scarce.…”

Section: Introductionmentioning

confidence: 99%

A retrospective cohort study evaluating healthcare resource utilization in patients with asthma in Japan

Inoue

Kozawa

Milligan

et al. 2019

npj Prim. Care Respir. Med.

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Although the global economic burden of asthma is well described, detailed data regarding Asia, particularly for Japan, are relatively scarce. This retrospective study aims to fill this evidence gap by evaluating asthma-associated healthcare resource utilization (HCRU) and economic burden in Japanese patients aged ≥16 years, identified using anonymized patient data from the Japan Medical Data Center (JMDC) database from April 2009 to March 2015. Asthma severity was classified according to asthma treatment guidelines from the Japanese Society of Allergology. HCRU was calculated based on hospitalizations, emergency room visits, outpatient visits, and prescriptions. Incidence rate ratios (IRRs) for HCRU and per-patient-per-year direct costs were reported. In addition, differences across HCRU and cost variables for severe versus non-severe asthma patients were also compared. Of 541,434 asthma cases identified from the JMDC database during the study period, 54,433 patients who met the inclusion criteria were included in this analysis. HCRU and costs were heavily concentrated within severe asthma, a subgroup comprising 12.7% of total study population. Moreover, patients with severe asthma had significantly higher all-cause hospitalizations, outpatient visits, outpatient prescriptions (IRR [95% CI], 1.60 [1.46–1.76]; 1.43 [1.41–1.45]; 1.24 [1.22–1.25], respectively), and total medical costs (mean ± SD costs, US$ 4345 ± 11,104 versus US$ 1528 ± 3989, P < 0.001 ( t -test); US$ 1 = 110 JPY) compared with those with non-severe asthma. The burden of asthma is significantly and disproportionately concentrated in Japanese severe asthma patients, suggesting clinical failure to achieve adequate disease control. This study highlights the unmet needs for severe asthma in Japan and provides a catalyst for important dialogues in advancing public health.

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Section: Introductionmentioning

confidence: 99%

A retrospective cohort study evaluating healthcare resource utilization in patients with asthma in Japan

Inoue

Kozawa

Milligan

et al. 2019

npj Prim. Care Respir. Med.

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“…In Japanese students, both seasonal and, in particular, perennial allergic rhinitis are significantly associated with a current wheeze [12]. A cross-sectional, observational study investigating real-world practice patterns for allergic rhinitis, asthma, chronic obstructive pulmonary disease, and rhinosinusitis in India, Korea, Malaysia, Singapore, Taiwan, and Thailand provided regional and country-specific information and suggested different practice patterns between specialists and general practitioners, and highlighted the substantial disease burden [13]. …”

Section: Characterization Of Subgroups Of Allergic Rhinitismentioning

confidence: 99%

Recent Advances in Clinical Allergy and Immunology

Simon

2018

Int Arch Allergy Immunol

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Allergic diseases are of great concern because of their high prevalence, which is still rising in several regions, their impact on patients’ physical and psychological health, the huge burden they place on patients’ quality of life, as well as the socioeconomic consequences that they cause. Recent research has provided new data on both genetic and environmental risk factors of atopic/allergic diseases. The application of new technologies such as “omics” has allowed a better understanding of the pathogenesis and has helped with the identification of therapeutic targets. Immense progress has been made in developing and applying novel, targeted therapies, for example for asthma and urticaria. Intensive efforts are being made to find biomarkers that help to classify patients, to identify their potential responsiveness to specific therapies, and to monitor the disease severity. Based on recent insights in the pathogenesis of food allergy and drug hypersensitivity, novel strategies for diagnostics, allergen avoidance, and induction of tolerance have been developed. Here, we summarize important findings in the field of clinical allergy and immunology with a special focus on asthma, allergic rhinitis, atopic dermatitis, food allergy, urticaria, angioedema, and drug hypersensitivity.

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“…[ 3 4 ] Although guidelines for the management of COPD are available for more than a decade,[ 5 ] a recent study indicated that the practice pattern is significantly different among physicians. [ 6 ] In hospital settings, a nurse-led model of COPD management has been proposed. [ 7 ] However, the evidence on the effectiveness of such models is not promising.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of a community health worker (CHW) training in monitoring and care of patients with chronic obstructive pulmonary disease (COPD) in rural Gujarat, India

Gupta¹,

Phatak²,

Patel

et al. 2020

J Family Med Prim Care

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Context: Chronic obstructive pulmonary disease (COPD) is the second leading contributor to the disease burden of India. The current COPD burden cannot be managed effectively just through a physician-based approach. In a primary care setting, community health workers (CHWs) can play an effective role in making COPD care accessible and effective. Aim: Findings of an assessment of a training program for CHWs on COPD have been reported here. Methods: 90 CHWs working as a part of a noncommunicable disease prevention and care program in a rural primary care setting were exposed to a series of five training sessions. The sessions were designed and administered jointly by a team of public health experts and physiotherapists in the year 2017–18. Topics covered were basic clinical aspects of COPD, monitoring a patient with COPD, and basic aspects of pulmonary rehabilitation. The assessment comprised 12 MCQs and short questions, 7 video exercises, 2 case vignettes, and 5 skill assessments through objectively structured clinical examination (OSCE). Statistical Analysis: Mean percentage scores were calculated for each domain of assessment to make it comparable. Results: 70 CHWs with a mean age of 42.2 years completed all the training and underwent the assessment. Mean percentage score (SD) for knowledge was 62% (16.3). In OSCE assessment, scores were best in sputum clearance technique demonstration (92.1%) and the least in dyspnea relieving positions (59.2%). The CHWs had difficulties in identifying signs of respiratory distress (score - 55.1%). No statistically significant association was observed between performance scores and their sociodemographic profile. Conclusion: The results were encouraging and the program may be pilot tested in a government setting particularly using the health and wellness centers (HWC) platform.

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Practice Patterns for Chronic Respiratory Diseases in the Asia-Pacific Region: A Cross-Sectional Observational Study

Cited by 7 publications

References 35 publications

A retrospective cohort study evaluating healthcare resource utilization in patients with asthma in Japan

A retrospective cohort study evaluating healthcare resource utilization in patients with asthma in Japan

Recent Advances in Clinical Allergy and Immunology

Effectiveness of a community health worker (CHW) training in monitoring and care of patients with chronic obstructive pulmonary disease (COPD) in rural Gujarat, India

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