Real-World Assessment of Asthma Control and Severity in Children, Adolescents, and Adults with Asthma: Relationships to Care Settings and Comorbidities

Nyenhuis, Sharmilee M.; Akkoyun, Esra; Liu, Li; Schatz, Michael; Casale, Thomas B.

doi:10.1016/j.jaip.2019.10.032

Cited by 20 publications

(13 citation statements)

References 28 publications

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“…However, this prevalence likely represents an overestimation because Asthma IQ was more commonly used by specialists than by primary care providers. 14 When examining trends in asthma specialist visits over a 10year period, we observed a trend of more specialist visits over time in all regions of the United States. The proportion of patients having a specialist visit increased by 43% overall, with reduced regional differences over time.…”

Section: Discussionmentioning

confidence: 84%

“…Existing literature on specialist visits is limited to the overall asthma population and analyses based on self-reported survey data 12,13 or clinical data contributed by providers. 14 Furthermore, there is little knowledge of how patient characteristics are associated with receiving specialist care. Such knowledge could help inform the need for specialist involvement with the care of patients with severe asthma and help mitigate the burden of disease and improve outcomes.…”

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confidence: 99%

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Real-World Assessment of Asthma Specialist Visits Among U.S. Patients with Severe Asthma

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Ambrose

Chung

et al. 2021

The Journal of Allergy and Clinical Immunology: In Practice

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Section: Discussionmentioning

confidence: 84%

mentioning

confidence: 99%

Real-World Assessment of Asthma Specialist Visits Among U.S. Patients with Severe Asthma

Most

Ambrose

Chung

et al. 2021

The Journal of Allergy and Clinical Immunology: In Practice

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“…Several other human and animal studies showed that OSA could shift the immune profile in patients with asthma from traditional eosinophilic or type 2 inflammation to neutrophilic or type 1 inflammation [ 16 , 18 , 19 ]. Additionally, real-world datasets showed an association between OSA and poor asthma control [ 20 ]. These studies showed that OSA may be a contributor to increased neutrophilrelated inflammation in asthma, leading to a more heterogeneous immune profile and poor disease control.…”

Section: Discussionmentioning

confidence: 99%

Effect of Obstructive Sleep Apnea on Immunity in Cases of Chronic Rhinosinusitis With Nasal Polyps

Kim

Lee

Park

et al. 2021

Clin Exp Otorhinolaryngol

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Objective: Chronic rhinosinusitis (CRS) with nasal polyp (wNP) is a more severe inflammatory form of CRS that often coexists with obstructive sleep apnea (OSA). However, little is known the relationship between OSA and immunologic profile on patients with CRSwNP. We aimed to investigate the immune profile of patients with CRSwNP according to OSA severity.Methods: This study included 63 patients with CRSwNP and nine control subjects. Protein levels of inflammatory mediators were determined using multiplex immunoassay. All patients underwent standard polysomnography.Results: We found that, in patients with eosinophilic CRSwNP (ECRSwNP), IL-6 and CXCL-1 (type 1 immune-related markers) were upregulated in cases of moderate-to-severe OSA. Additionally, IL-4, IL-13, CCL-11, CCL-24 (type 2 immune-related markers), and IL-17A (type 3 immune-related marker) were increased in patients with moderate-to-severe OSA. Though there were no significant differences in type 1, 2, or 3 immune-related markers among patients with non-eosinophilic CRSwNP (NECRSwNP) according to the severity of OSA, TGF-

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“…Although there has been limited research examining outcomes for children with medical conditions cared for by general or subspecialty pediatricians and by adult or pediatric subspecialists, differences in knowledge, patient characteristics, and processes of care have been described. [51][52][53] New initiatives to enrich the training of pediatric residents in fields with a paucity of pediatric subspecialists could help decrease reliance on subspecialists for some conditions and concerns. 54 The allocation of time to direct patient care may reduce available clinic appointments within some subspecialties.…”

Section: Discussionmentioning

confidence: 99%

Growth and changes in the pediatric medical subspecialty workforce pipeline

et al. 2020

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Background To inform discussions of pediatric subspecialty workforce adequacy and characterize its pipeline, we examined trends in first-year fellows in the 14 American Board of Pediatrics (ABP)-certified pediatric medical subspecialties, 2001–2018. Methods Data were obtained from the ABP Certification Management System. We determined, within each subspecialty, the annual number of first-year fellows. We assessed for changes in the population using variables available throughout the study period (gender, medical school location, program region, and program size). We fit linear trendlines and calculated χ 2 statistics. Results The number of first-year pediatric medical subspecialty fellows increased from 751 in 2001 to 1445 in 2018. Fields with the growth of 3 or more fellows per year were Cardiology, Critical Care, Emergency Medicine, Gastroenterology, Neonatology, and Hematology Oncology ( P value <0.05 for all). The number of fellows entering Adolescent Medicine, Child Abuse, Infectious Disease, and Nephrology increased at a rate of 0.5 fellows or fewer per year. Female American Medical Graduates represented the largest and growing proportions of several subspecialties. Distribution of programs by region and size were relatively consistent over time, but varied across subspecialties. Conclusions The number of pediatricians entering medical subspecialty fellowship training is uneven and patterns of growth differ between subspecialties. Impact The number of individuals entering fellowship training has increased between 2001 and 2018. Growth in the number of first-year fellows is uneven. Fields with the greatest growth: Critical Care, Emergency Medicine, and Neonatology. Fields with limited growth: Adolescent Medicine, Child Abuse, Infectious Disease, and Nephrology. Concerns about the pediatric medical subspecialty workforce are not explained by the number of individuals entering the fellowship.

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Real-World Assessment of Asthma Control and Severity in Children, Adolescents, and Adults with Asthma: Relationships to Care Settings and Comorbidities

Cited by 20 publications

References 28 publications

Real-World Assessment of Asthma Specialist Visits Among U.S. Patients with Severe Asthma

Real-World Assessment of Asthma Specialist Visits Among U.S. Patients with Severe Asthma

Effect of Obstructive Sleep Apnea on Immunity in Cases of Chronic Rhinosinusitis With Nasal Polyps

Growth and changes in the pediatric medical subspecialty workforce pipeline

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