Repeated exacerbation of asthma: An intrinsic phenotype of uncontrolled asthma

Jain, Neeraj; S, Satish K; Abhyankar, Nitin; Velayudhan, Nila; Gurunathan, Jayakumar

doi:10.4103/lungindia.lungindia_434_17

Cited by 13 publications

(12 citation statements)

References 55 publications

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“…On the basis that increased SABA use is a marker of poor asthma control [ 1 ], it is possible that this group of paediatric patients who may suffer more frequent and severe exacerbations have exacerbation-prone phenotypes [ 34 ]. Current asthma treatment and prevention strategies increasingly emphasise the need to improve asthma control.…”

Section: Discussionmentioning

confidence: 99%

Short-acting β₂-agonists and exacerbations in children with asthma in England: SABINA Junior

et al. 2023

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BackgroundPrescription of ≥3 short-acting β2-agonist (SABA) canisters/year in adult and adolescent asthma populations is associated with a risk of severe exacerbations; however, evidence in children aged <12 years is limited.MethodsThis study analysed data on children and adolescents with asthma in three age cohorts: 1‒5#, 6‒11#, and 12‒17# years from the Clinical Practice Research Datalink Aurum database for the period of 1/1/07-31/12/19. Associations between SABA prescriptions (≥3versus<3 canisters/year) at baseline, defined as 6 months after an asthma diagnosis as a binary exposure variable, and the rate of future asthma exacerbations, defined as oral corticosteroid burst therapy, an emergency department visit, or hospital admission, were assessed by multilevel, negative binomial regression, adjusted for relevant demographic and clinical confounders.ResultsOverall 48#,560, 110,091 and 111,891 paediatric patients with asthma were aged 1‒5#, 6‒11# years and 12‒17# years, respectively. During the baseline period, 22,423 (46.2#%), 42,137 (38.3#%) and 40,288 (36.0#%) in these three age cohorts were prescribed ≥3 SABA canisters/year, respectively. Across all age ranges, the rate of future asthma exacerbations in those prescribed ≥3versus<3 SABA canisters/year was ≥2-fold higher. More than 30% of patients across all age cohorts were not prescribed inhaled corticosteroids (ICS) and the median proportion of days covered was only 33%, suggesting inadequate prescribing of ICS.ConclusionIn children, higher SABA prescriptions at baseline were associated with increased, future exacerbation rates. These findings highlight the need for monitoring prescription of ≥3 SABA canisters/year to identify children with asthma at risk of exacerbations.

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Section: Discussionmentioning

confidence: 99%

Short-acting β₂-agonists and exacerbations in children with asthma in England: SABINA Junior

et al. 2023

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“…They can also increase self-efficacy (63) and create positive self-management behavioral changes like inhaler use, medication adherence, regular exercise, and followup visits (63,64). They can drive understanding and knowledge (64,65), and bring about reductions in both the inappropriate usage of medications and unscheduled visits (31). It was also observed that such self-management programmes facilitate the identification of hurdles to self-management, and they can inform strategies that can improve understanding and health literacy (28).…”

Section: Discussionmentioning

confidence: 99%

Investigating the Outcomes of an Asthma Educational Program and Useful Influence in Public Policy

Dailah

2021

Front. Public Health

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The study was conducted to evaluate the effectiveness of an asthma educational program for asthma control, asthma self-management, asthma knowledge, and patient activation. The study analyzes different demographic variables with the purpose of investigating which asthma patients performed better than others. Based on these demographic characteristics, the study provides several recommendations for various stakeholders. The study is based on a positivist approach since its purpose is to investigate the consequences of an asthma educational program with a view to generalizing the results to a larger population. The study targets public and private hospitals which have applied the asthma educational program in collaboration with the Saudi Initiative for Asthma (SINA). Multiple questionnaires were deployed 263 valid responses were received from patients of public and private hospitals using online and offline data collection method. Several parametric and non-parametric tests were carried out in terms of data analysis. The results reveal that patients in the intervention group obtained high scores and were therefore more knowledgeable and able to control their asthma compared to the control group. Overall, patients in the intervention group performed better in terms of asthma control, asthma self-management and knowledge and awareness. There was a high level of patient activation in this group. In the context of demographic features, it was found that patients who are married and are undergraduate degree holders in employment scored high compared to patients who were young, single, post-graduate degree holders that were mainly self-employed. The results of this study can guide policy makers, SINA authorities, and hospitals as to which demographic category of asthma patients require immediate attention. The significance of asthma educational programmes has increased especially through social media platforms as the number of adult patients continues to increase day by day.

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“…Furthermore, there is a group of asthmatic patients called exacerbation-prone phenotype who experience even more frequent and severe exacerbations than other ones. [13] Beyond the clinical impact of the disease, an important economic burden is also observed. [6,14,15] A total annual average cost (both direct and indirect costs) of 2208 Brazilian Real (BRL) per patient over the period 2008 to 2013 was estimated for Brazilian patients followed in the public healthcare system.…”

Section: All Data Generated or Analyzed During This Study Are Include...mentioning

confidence: 99%

“…Furthermore, there is a group of asthmatic patients called exacerbation-prone phenotype who experience even more frequent and severe exacerbations than other ones. [ 13 ]…”

Section: Introductionmentioning

confidence: 99%

The economic impact of asthma on private healthcare system in Brazil: Economic impact of asthma in Brazil

et al. 2023

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To assess healthcare resource utilization and costs of patients with asthma in Brazilian Supplementary Healthcare System, focusing on hospitalization data. Retrospective cohort study, using data from an administrative database of a private company (Orizon). Patients aged ≥ 12 years with at least one record of emergency visit/hospitalization in the database with the ICD-10 J45 between January/2010 and June/2015 were included and followed until June/2016, death or inactivation of health plan. Sociodemographic characteristics, emergency visit and hospital admission per patient per year (exacerbation rate), physician visit with a procedure, exams, length of hospitalization (with/without intensive care unit (ICU)), and in-hospital treatments were assessed. A total of 54,568 patients were included in this analysis. Regarding resource utilization, emergency visit and hospital admission rates of 0.34 and 0.04 per person-year were observed, respectively. Mean length of hospital stay were 8.82 (SD = 36.48), 5.24 (SD = 19.06) and 19.53 (63.89) days for hospitalizations in general, without and with ICU, respectively. An exacerbation rate of 0.36 per person year was observed with a mean cost per episode of 3178 Brazilian Real (BRL) (SD = 31,667). Mean cost related to emergency department visits was estimated at 293 BRL (SD = 328). Hospitalization costs were stratified by the need of ICU and values observed were of 9307 BRL (SD = 18,979) without ICU, and 75,252 BRL (SD = 174,248) with ICU need. Asthma exacerbations may cost ~75,000 BRL for an ICU-dependent event in the Supplementary Healthcare System. To improve disease control may reduce disease burden for both healthcare system and patients.

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Repeated exacerbation of asthma: An intrinsic phenotype of uncontrolled asthma

Cited by 13 publications

References 55 publications

Short-acting β₂-agonists and exacerbations in children with asthma in England: SABINA Junior

Short-acting β₂-agonists and exacerbations in children with asthma in England: SABINA Junior

Investigating the Outcomes of an Asthma Educational Program and Useful Influence in Public Policy

The economic impact of asthma on private healthcare system in Brazil: Economic impact of asthma in Brazil

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Repeated exacerbation of asthma: An intrinsic phenotype of uncontrolled asthma

Cited by 13 publications

References 55 publications

Short-acting β2-agonists and exacerbations in children with asthma in England: SABINA Junior

Short-acting β2-agonists and exacerbations in children with asthma in England: SABINA Junior

Investigating the Outcomes of an Asthma Educational Program and Useful Influence in Public Policy

The economic impact of asthma on private healthcare system in Brazil: Economic impact of asthma in Brazil

Contact Info

Product

Resources

About

Short-acting β₂-agonists and exacerbations in children with asthma in England: SABINA Junior

Short-acting β₂-agonists and exacerbations in children with asthma in England: SABINA Junior