Quality Indicators of Asthma Care Derived From the Spanish Guidelines for Asthma Management (GEMA 4.0): A Multidisciplinary Team Report

Quirce, Santiago; Delgado, J.; Entrenas, LM; Grande, M; Llorente, César; López-Viña, Antolín; Moragón, Eva Martínez; Mascarós, Enrique; Molina, Jesús; Olaguibel, JM; Llano, L. Pérez de; Tordera, Miguel Perpiñá; Quintano, JA; Rodríguez, M.; Román-Rodríguez, Miguel; Sastre, Joaquı́n; Trigueros, JA; Valero, A; Zoni, AC; Plaza, Vicente

doi:10.18176/jiaci.0121

Cited by 8 publications

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“…The treatment of asthma exacerbations is complex, since many patients continue to have asthma-related symptoms at home once they have been discharged from the ED [18]. The rising frequency of asthma exacerbations indicates that management of the disease continues to be suboptimal [18][19][20][21].…”

Section: Discussionmentioning

confidence: 99%

Asthma Exacerbations in the Pediatric Emergency Department at a Tertiary Hospital: Association With Environmental Factors

Mejías¹,

Pérez²,

Hernández³

et al. 2019

J Investig Allergol Clin Immunol

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Introduction: Children with asthma experience recurrent respiratory symptoms and exacerbations due to multiple environmental factors. The aim of this study was to describe the prevalence and triggers of asthma exacerbations and their management in a cohort of pediatric patients attended in an emergency department (ED). Methods: We performed an observational, retrospective, single-center study in the pediatric ED of Hospital Universitario La Paz, Madrid, Spain in 2015. Children with asthma exacerbations attending the ED were included after a thorough search using our institutional computer database. Pollen and atmospheric mold spore counts and pollution data were collected for that period from official websites. Multiple logistic regression was used to assess the association between daily pollution (NO 2 , PM 10 , ozone, pollen, and molds) and admissions to the ED because of asthma. Results: During 2015, a total of 50 619 patients were attended in the ED of our hospital. Of these, 2609 (5%) were diagnosed with asthma exacerbation/bronchospasm. The patient had to be admitted to hospital in 21.7% of cases. The main triggers of asthma exacerbations were respiratory infection in 1841 cases (70.6%). A significant correlation was found between grass pollen counts and ED admissions (P<.0001). A positive correlation was also found between ED admissions and NO 2 0.58 (95%CI, 0.02-0.87) and PM 10 0.75 (95%CI, 0.31-0.93) (P<.05). Conclusion: Environmental factors such as grass pollen counts and pollution (NO 2 and PM 10 ) are associated with a higher frequency of admission to the ED.

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Section: Discussionmentioning

confidence: 99%

Asthma Exacerbations in the Pediatric Emergency Department at a Tertiary Hospital: Association With Environmental Factors

Mejías¹,

Pérez²,

Hernández³

et al. 2019

J Investig Allergol Clin Immunol

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“…The multiple factors involved (immunologic, psychological, uncommon allergic triggers, and menstruation) make the management of this patient quite complex. The case illustrates that periodic monitoring remains essential to regain asthma control [10]. Similarly, in a case of PMA in a patients with a hormonal implant (such as that reported here), loss of efficacy should be suspected.…”

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confidence: 70%

Worsening of Severe Asthma Due to Menstruation and Sensitization to Albumins

Marques-Mejías¹,

Paredes²,

Laorden³

et al. 2018

J Investig Allergol Clin Immunol

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“…Reducing the risk of exacerbations is an important goal of asthma treatment 3–5. It is estimated that 30%–52% of patients with asthma have exacerbations of varying intensity 2 6.…”

Section: Introductionmentioning

confidence: 99%

Treatment persistence and exacerbations in patients with asthma initiating treatment with inhaled corticosteroids and beta-adrenergic agonists: retrospective cohort study

et al. 2022

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ObjectiveTo determine treatment persistence and exacerbations in patients initiating inhaler treatment with fixed-dose combinations of inhaled corticosteroids/long-acting beta-2-adrenergic agonists (ICS/LABA) for the treatment of asthma.DesignRetrospective observational study conducted by review of electronic medical records (database: Fundación RediSS).SettingRetrospective cohort study. The follow-up period was 1 year.ParticipantsThe study included patients aged ≥18 years who started treatment with ICS/LABA and met the inclusion/exclusion criteria.Main outcomes and measuresThe study groups were fluticasone propionate/salmeterol (FP/SAL), beclomethasone/formoterol (BDP/FORM), budesonide/formoterol (BUD/FORM), fluticasone furoate/vilanterol (FF/VI) and fluticasone propionate/formoterol (FP/FORM). The main measurements were persistence, medication possession ratio (MPR) and exacerbations. Statistical significance was established as p<0.05.ResultsIn total, 3203 patients were recruited for the study. By groups, 31.1% FP/SAL, 28.6% BDP/FORM, 25.0% BUD/FORM, 8.2% FF/VI and 7.0% FP/FORM. The mean age was 52.2 years, 60.8% were female and 44.9% had persistent-moderate asthma. Treatment persistence was 61.7% (95% CI 60.0% to 63.4%) and by study group it was FP/SAL: 60.7%, BDP/FORM: 61.2%, BUD/FORM: 60.3%, FF/VI: 66.7% and FP/FORM: 67.6% (p=0.046). MPR by study group was FP/SAL: 74.3%, BDP/FORM: 73.8%, BUD/FORM: 74.6%, FF/VI: 79.4% and FP/FORM: 80.6% (p=0.028). The mortality rate was 2.9%. By treatment group, exacerbations were FP/SAL: 21.9% (95% CI 19.3% to 24.5%), BDP/FORM: 22.2% (95% CI 19.5% to 24.9%), BUD/FORM: 22.8% (95% CI 19.9% to 25.7%), FF/VI: 17.9% (95% CI 14.9% to 20.7%) and FP/FORM: 16.0% (95% CI 12.2% to 19.3%), p=0.036.ConclusionsPatients undergoing treatment with FP/FORM and FF/VI versus FP/SAL, BDP/FORM and BUD/FORM were associated with greater treatment adherence (persistence, MPR) and lower rates of exacerbations. However, further studies will be needed to strengthen the consistency of the results.

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Quality Indicators of Asthma Care Derived From the Spanish Guidelines for Asthma Management (GEMA 4.0): A Multidisciplinary Team Report

Abstract: Tumores gastrointestinales malignos. Oxaliplatino. Reacción de hipersensibilidad a oxaliplatino. Infusión prolongada. Infusión estándar.

Cited by 8 publications

References 0 publications

Asthma Exacerbations in the Pediatric Emergency Department at a Tertiary Hospital: Association With Environmental Factors

Asthma Exacerbations in the Pediatric Emergency Department at a Tertiary Hospital: Association With Environmental Factors

Worsening of Severe Asthma Due to Menstruation and Sensitization to Albumins

Treatment persistence and exacerbations in patients with asthma initiating treatment with inhaled corticosteroids and beta-adrenergic agonists: retrospective cohort study

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