scholarly journals Asthma Control in Canada Remains Suboptimal: The Reality of Asthma Control (TRAC) Study

2006 ◽  
Vol 13 (5) ◽  
pp. 253-259 ◽  
Author(s):  
J Mark FitzGerald ◽  
Louis-Philippe Boulet ◽  
R Andrew McIvor ◽  
Sabrina Zimmerman ◽  
Kenneth R Chapman
Keyword(s):  
Asthma Control ◽  
Inhaled Corticosteroids ◽  
Guideline Implementation ◽  
Effective Means ◽  
Smoking History ◽  
Chronic Obstructive ◽  
Action Plans ◽  
Obstructive Pulmonary Disease ◽  
Asthma Knowledge ◽  
Almost All

BACKGROUND: Two Canadian studies showed that 55% of patients with asthma had daily symptoms (in 1996) and that 57% of patients suffered from poorly controlled asthma (in 1999).OBJECTIVES: To assess the state of asthma control of adult Canadians, and asthma knowledge and practices of Canadian physicians actively involved in the care of patients with asthma.METHODS: Telephone interviews were conducted with adults 18 to 54 years of age who had been diagnosed with asthma at least six months before the survey, who did not have chronic obstructive pulmonary disease and who had a smoking history of fewer than 20 pack-years. Physicians were surveyed by telephone and mail. The surveys took place between April and August 2004.RESULTS: Almost all (97%) of the 893 patients believed that they had controlled asthma; however, only 47% had controlled disease according to symptom-based guideline criteria. Just 39% of 463 physicians based their treatment recommendations on the Canadian asthma guidelines most or all of the time, despite having a high awareness of them. Only 11% of patients had written action plans, and one-half of patients with action plans did not use them regularly. Almost three-quarters of patients expressed concerns about taking inhaled corticosteroids.CONCLUSIONS: Since the last major national survey, guideline implementation has not resulted in significant changes in asthma-related morbidity. Effective means of knowledge transfer should be developed and implemented to improve the translation of guideline recommendations into care.

scholarly journals Use of the inhaled corticosteroid to bronchodilator ratio in an audit of the treatment of asthma in an academic family medicine residency programme

2010 ◽  
Vol 2 (1) ◽  
pp. 22
Author(s):  
Paul Pisarik
Keyword(s):  
Family Medicine ◽  
Asthma Control ◽  
Inhaled Corticosteroids ◽  
The United States ◽  
Chronic Obstructive ◽  
Inhaled Corticosteroid ◽  
Asthma Care ◽  
Bronchodilator Agents ◽  
Obstructive Pulmonary Disease ◽  
The Difference

INTRODUCTION: Asthma affects around 5% of the United States population, with 50% having uncontrolled symptoms. AIM: To improve asthma care by seeing if the inhaled corticosteroid to bronchodilator ratio (RATIO) is associated with asthma control and if non-clinical factors were associated with adherence to asthma guidelines. METHOD: A retrospective study using University of Oklahoma-Tulsa, School of Community Medicine Family Medicine Clinic electronic medical records of a random sample of 49 patients with asthma who were seen at least twice from July 2003 through June 2007 and did not have a diagnosis of chronic obstructive pulmonary disease or exercise-induced asthma. RESULTS: The RATIO for those prescribed corticosteroid inhalers was directly related to the actual step of asthma care (STEP) but inversely related to the number of prednisone courses prescribed per year (R2=.30, p=0.0012). The difference between the actual STEP and ideal STEP (had corticosteroid inhalers been prescribed for all the months in the study) was directly related to the percent of available salbutamol (albuterol) inhalers that non-clinicians refilled and inversely related to the actual STEP (R2=.45, p=1.8 x 10-5). The available corticosteroid inhalers prescribed was directly related to the actual STEP and inversely related to the number of comorbid diagnoses addressed at the last asthma visit (R2=.70, p=5.8 x 10-10). DISCUSSION: Efforts to both limit salbutamol medications, especially by non-clinicians, and simultaneously prescribe appropriate amounts of inhaled corticosteroids, through a dedicated asthma visit, should improve asthma control. A higher RATIO implies better asthma control. KEYWORDS: Asthma; anti-inflammatory agents; albuterol; bronchodilator agents; drug therapy, combination; medical audit

scholarly journals New GOLD COPD Guideline 2019: How We Deal with It? (Inhaled Corticosteroid Use and Blood Eosinophil Count)

2021 ◽  
Vol 1 (2) ◽  
pp. 79-87
Author(s):  
Ari Julian Saputra ◽  
Kiki Widyastuti ◽  
Yusup Subagio Sutanto
Keyword(s):  
Eosinophil Count ◽  
Inhaled Corticosteroids ◽  
Low Cost ◽  
Smoking History ◽  
Chronic Obstructive ◽  
Blood Eosinophil ◽  
Obstructive Pulmonary Disease ◽  
Blood Eosinophil Count ◽  
Blood Eosinophils ◽  
Group D

Background: Blood eosinophils may predict response to inhaled corticosteroids (ICS) in chronic obstructive pulmonary disease (COPD), where ICS is recommended in patients at high risk of exacerbations by the Global Initiative for COPD (GOLD) strategy. It can help clinicians to estimate the likelihood of beneficial preventive responses to the addition ICS to regular bronchodilator treatment, and thus can be used as a biomarker in conjunction with clinical assessment when making decisions regarding ICS use. This study aims to compare therapeutic data with blood eosinophil count in COPD patients. Methods: Data were collected from consecutive COPD outpatients in Bukit Asam Medika Hospital starting from March 1st, 2019 until June 30th, 2019 and dr. H. Mohamad Rabain Hospital starting from Oct 1st, 2019 until Dec 27th, 2019. We collected demographics, anthropometrics, smoking history, therapy, dynamic lung volumes, the Medical Research Council scale (MRC), CAT score, and blood eosinophil count. Results: From 57 data collected, 24 (42,1%) patients were having blood eosinophil count ≥300. Patients who have more exacerbation in COPD Group C were 33,3% and 63,2% in COPD Group D. The proportions of ICS-treated COPD Group D patients and blood eosinophil count of <300 and ≥300 was 63,9% and 36,1%, respectively. Conclusion: This study may provide information and characteristic of COPD patient in Indonesia rural area and showed who may have benefit to ICS therapy based on recommendation GOLD COPD 2019. Blood eosinophils counts is a low-cost biomarker and may help clinicians to made decision therapy.

Inhaled corticosteroids for chronic obstructive pulmonary disease

BMJ ◽  
2012 ◽  
Vol 345 (oct25 1) ◽  
pp. e6843-e6843 ◽  
Author(s):  
H. Y. Park ◽  
S. F. P. Man ◽  
D. D. Sin
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Inhaled Corticosteroids ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease

scholarly journals Understanding racial differences of COPD patients with an ecological model: two large cohort studies in the US and Korea

2021 ◽  
Vol 12 ◽  
pp. 204062232098245
Author(s):  
Hye Yun Park ◽  
Hyun Lee ◽  
Danbee Kang ◽  
Hye Sook Choi ◽  
Yeong Ha Ryu ◽  
...  
Keyword(s):  
Racial Differences ◽  
Large Scale ◽  
Ecological Model ◽  
Prevalence Ratio ◽  
Poor Quality ◽  
Smoking History ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
The Us

Background: There are limited data about the racial difference in the characteristics of chronic obstructive pulmonary disease (COPD) patients who are treated at clinics. We aimed to compare sociodemographic and clinical characteristics between US and Korean COPD patients using large-scale nationwide COPD cohorts. Methods: We used the baseline demographic and clinical data of COPD patients aged 45 years or older with at least a 10 pack-per year smoking history from the Korean COPD Subtype Study (KOCOSS, n = 1686) cohort (2012–2018) and phase I (2008–2011) of the US Genetic Epidemiology of COPD (COPDGene) study ( n = 4477, 3461 were non-Hispanic whites [NHW], and 1016 were African Americans [AA]). Results: Compared to NHW, AA had a significantly lower adjusted prevalence ratio (aPR) of cough >3 months (aPR: 0.67; 95% CI [confidence interval]: 0.60–0.75) and phlegm >3 months (aPR: 0.78, 95% CI: 0.70–0.86), but higher aPR of dyspnea (modified Medical Round Council scale ⩾2) (aPR: 1.22; 95% CI: 1.15–1.29), short six-minute walk distance (<350 m) (aPR: 1.98; 95% CI: 1.81–2.14), and poor quality of life (aPR: 1.10; 95% CI: 1.05–1.15). Compared to NHW, Koreans had a significantly lower aPR of cough >3 months (aPR: 0.53; 95% CI: 0.47–0.59), phlegm >3 months (aPR: 0.75; 95% CI: 0.67–0.82), dyspnea (aPR: 0.72; 95% CI: 0.66–0.79), and moderate-to-severe acute exacerbation in the previous year (aPR: 0.73; 95% CI: 0.65–0.82). NHW had the highest burden related to chronic bronchitis symptoms and cardiovascular diseases related to comorbidities. Conclusion: There are substantial differences in sociodemographic characteristics, clinical presentation, and comorbidities between COPD patients from the KOCOSS and COPDGene, which might be caused by interactions between various intrapersonal, interpersonal, and environmental factors of the ecological model. Thus, a broader and more comprehensive approach would be necessary to understand the racial differences of COPD patients.

Current opportunities of inhaled corticosteroid therapy in patients with chronic obstructive pulmonary disease

2021 ◽  
Vol 31 (1) ◽  
pp. 75-87
Author(s):  
I. V. Leshchenko ◽  
A. S. Meshcheryakova
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Inhaled Corticosteroids ◽  
Fixed Combination ◽  
Chronic Obstructive ◽  
Delivery Device ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Long Acting ◽  
Blood Eosinophils

Chronic obstructive pulmonary disease (COPD) is the leading cause of death in the structure of respiratory diseases. The problem of rational pharmacotherapy of COPD have attracted attention of the medical scientific society for many years. The understanding of the pathogenesis of the disease has deepened and approaches to the therapy have changed. Some COPD patients need regular fixed-combination therapy: long-acting bronchodilators (LABD) and inhaled corticosteroids (ICS) in order to prevent exacerbations and reduce the severity of symptoms of the disease. Blood eosinophils count is one of criteria for choosing regular therapy. The appearance of fixed triple combinations of ICS/LABD increased the effectiveness of COPD therapy, and a new delivery device for fixed combination of budesonide/formoterol makes it possible to use ICS successfully in the most severe patients.

Patterns of use and trends in the use of medications for the control of COPD in a cohort of Colombian patients, 2017-2019 v1

2021 ◽  
Author(s):  
Jorge Machado Alba
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Inhaled Corticosteroids ◽  
Chronic Obstructive ◽  
Population Database ◽  
Obstructive Pulmonary Disease ◽  
Prescription Patterns ◽  
Short Acting ◽  
Patterns Of Use ◽  
Long Acting

Introduction: Chronic obstructive pulmonary disease (COPD) affects approximately 174 million people worldwide.The objective was to determine the trends of the use of medications for COPD in a group of Colombian patients. Methods: This was a retrospective study on prescription patterns of bronchodilators and other medications used in COPD from a population database with follow-up at 12 and 24 months. Patients older than 18 years of age of any sex who had COPD between 2017 and 2019 were included. Sociodemographic variables, medications, treatment schedules for COPD, comorbidities, comedications, and the specialty of the prescriber were considered. Results: A total of 9,476 people with a diagnosis of COPD were evaluated. They had a mean age of 75.9 ± 10.7 years, 50.1% were men, and 86.8% were prescribed by a general practitioner. At the beginning of the follow-up, on average, they received 1.6 medications/patient, mainly short-acting antimuscarinics (3784; 39.9%), followed by short-acting β-agonists (2997, 31.6%) and inhaled corticosteroids (ICS) (2239, 23.6%), but 5083 (53.6%) patients received a long-acting bronchodilator. At the beginning of the follow-up, 645 (6.8%) patients were put on triple therapy with antimuscarinics, β-agonists, and ICS, and at 12 months, this rose to 1388 (20.6%). A total of 57.9% had comorbidities, most often hypertension (44.4%). Conclusions: This group of patients with COPD treated in Colombia frequently received short-acting bronchodilators and ICS, but a growing proportion are undergoing controlled therapy with long-acting bronchodilators, a situation that can improve the indicators of morbidity, exacerbations, and hospitalization.

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