Fulvio Braido1, Ilaria Baiardini2, Pietro Alleri3, Elena Bacci4, Carlo Barbetta5, Michela Bellocchia6, Alida Benfante7, Francesco Blasi8, Caterina Bucca6, Maria Teresa Busceti9, Stefano Centanni10, Maria Cristina Colanardi11, Marco Contoli5, Angelo Corsico12, Maria D'Amato13, Fabiano Di Marco10, Dottorini Marco3, Marta Ferrari2, Giovanni Florio14, Alessandro Giuseppe Fois15, Maria Pia Foschino Barbaro16, Garuti Silvia2, Giuseppe Girbino17, Amelia Grosso18, Manuela Latorre4, Sara Maniscalco19, Francesco Mazza20, Carlo Mereu19, Giorgia Molinengo21, Josuel Ora22, Pierluigi Paggiaro4, Vincenzo Patella23, Girolamo Pelaia9, Pietro Pirina15, Alfio Proietto17, Paola Rogliani22, Pierachille Santus24, Nicola Scichilone7, Francesca Simioli14, Paolo Solidoro6, Silvia Terraneo10, Umberto Zuccon20, Giorgio Walter Canonica25. 1. Allergy & Respiratory Diseases, Department of Internal Medicine- University of Genoa, Italy. Electronic address: fulvio.braido@unige.it. 2. Allergy & Respiratory Diseases, Department of Internal Medicine- University of Genoa, Italy. 3. Servizio di Riabilitazione Respiratoria e prevenzione Tisiopneumologica USL, Perugia, Umbria 1, Italy. 4. Cardio-Thoracic and Vascular Department, University of Pisa, Italy. 5. Section of Respiratory Diseases Department of Medical Sciences - University of Ferrara, Italy. 6. Medical Science, University of Turin, Italy. 7. Department of Internal Medicine, University of Palermo, Italy. 8. Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Cardio-thoracic unit and Cystic Fibrosis Adult Center Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico Milano, Italy. 9. Department of Medical and Surgical Sciences, Section of Respiratory Diseases, University "Magna Græcia" of Catanzaro, Italy. 10. Respiratory Unit, San Paolo Hospital, Department of Medical Sciences, University of Milan, Milan, Italy. 11. Malattie Apparato Respiratorio. Universitaria Azienda Ospedaliero-universitaria Ospedali Riuniti di Foggia, Italy. 12. Pneumology Unit, Department of Internal Medicine and Medical Therapy, San Matteo Polyclinic and Institute for Scientific Research, University of Pavia, Italy. 13. Unit of Pneumotisiology, Monaldi-AO Dei Colli Hospital, Federico II University, Naples, Italy. 14. Federico II University, Naples, Italy. 15. Department of Respiratory Diseases, Azienda Ospedaliero Universitaria di Sassari, Italy. 16. Department of Medical and Surgical Sciences, University of Foggia, Italy. 17. Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Section of Respiratory Diseases, University of Messina, Policlinico Universitario "G.Martino", Messina, Italy. 18. Department of Internal Medicine and Medical Therapy, University of Pavia, Italy. 19. Pulmonology Department, Santa Corona Hospital, Pietra Ligure, Savona, Italy. 20. Presidio Ospedaliero di Pordenone, Italy. 21. Department of Psychology, University of Turin, Italy. 22. Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy. 23. Allergy and Clinical Immunology Division, Battipaglia Hospital, Department of Medicine ASL Salerno, Italy. 24. University of Milan, Respiratory Unit, L. Sacco Hospital, ASST Fatebenefratelli Sacco, Milano, Italy. 25. Personalized Medicine Clinic: Asthma & Allergy - Humanitas Clinical and Research Center, Department of Biomedical Science, Humanitas University -Rozzano Milano, Italy.
Abstract
BACKGROUND: Asthma considerably impairs patients' quality of life and increases healthcare costs. Severity, morbidity, and degree of disease control are the major drivers of its clinical and economic impact. National scientific societies are required to monitor the application of international guidelines and to adopt strategies to improve disease control and better allocate resources. AIM: to provide a detailed picture of the characteristics of asthma patients and modalities of asthma management by specialists in Italy and to develop recommendations for the daily management of asthma in a specialist setting. METHOD: A quantitative research program was implemented. Data were collected using an ad hoc questionnaire developed by a group of specialists selected by the Italian Pneumology Society/Italian Respiratory Society. RESULTS: The records of 557 patients were analyzed. In the next few years, specialists are expected to focus their activity patients with more severe disease and will be responsible for selection of patients for personalized biological therapy; however, only 20% of patients attending Italian specialist surgery can be considered severe. In 84.4% of cases, the visit was a follow-up visit requested in 82.2% of cases by the specialist him/herself. The Asthma Control Test is used only in 65% of patients. When available, a significant association has been observed between the test score and asthma control as judged by the physician, although concordance was only moderate (κ = 0.68). Asthma was considered uncontrolled by the specialist managing the case in 29.1% of patients; nevertheless, treatment was not stepped up in uncontrolled or partly controlled patients (modified in only 37.2% of patients). CONCLUSIONS: The results of this survey support re-evaluation of asthma management by Italian specialists. More resources should be made available for the initial visit and for more severely ill patients. In addition, more extensive use should be made of validated tools, and available drugs should be used more appropriately.
BACKGROUND:Asthma considerably impairs patients' quality of life and increases healthcare costs. Severity, morbidity, and degree of disease control are the major drivers of its clinical and economic impact. National scientific societies are required to monitor the application of international guidelines and to adopt strategies to improve disease control and better allocate resources. AIM: to provide a detailed picture of the characteristics of asthmapatients and modalities of asthma management by specialists in Italy and to develop recommendations for the daily management of asthma in a specialist setting. METHOD: A quantitative research program was implemented. Data were collected using an ad hoc questionnaire developed by a group of specialists selected by the Italian Pneumology Society/Italian Respiratory Society. RESULTS: The records of 557 patients were analyzed. In the next few years, specialists are expected to focus their activity patients with more severe disease and will be responsible for selection of patients for personalized biological therapy; however, only 20% of patients attending Italian specialist surgery can be considered severe. In 84.4% of cases, the visit was a follow-up visit requested in 82.2% of cases by the specialist him/herself. The Asthma Control Test is used only in 65% of patients. When available, a significant association has been observed between the test score and asthma control as judged by the physician, although concordance was only moderate (κ = 0.68). Asthma was considered uncontrolled by the specialist managing the case in 29.1% of patients; nevertheless, treatment was not stepped up in uncontrolled or partly controlled patients (modified in only 37.2% of patients). CONCLUSIONS: The results of this survey support re-evaluation of asthma management by Italian specialists. More resources should be made available for the initial visit and for more severely ill patients. In addition, more extensive use should be made of validated tools, and available drugs should be used more appropriately.
Authors: Michelle M Cloutier; Lara J Akinbami; Paivi M Salo; Michael Schatz; Tregony Simoneau; Jesse C Wilkerson; Gregory Diette; Kurtis S Elward; Anne Fuhlbrigge; Jacek M Mazurek; Lydia Feinstein; Sonja Williams; Darryl C Zeldin Journal: J Allergy Clin Immunol Pract Date: 2020-04-25
Authors: Anne M Fitzpatrick; Stanley J Szefler; David T Mauger; Brenda R Phillips; Loren C Denlinger; Wendy C Moore; Ronald L Sorkness; Sally E Wenzel; Peter J Gergen; Eugene R Bleecker; Mario Castro; Serpil C Erzurum; John V Fahy; Benjamin M Gaston; Elliot Israel; Bruce D Levy; Deborah A Meyers; W Gerald Teague; Leonard B Bacharier; Ngoc P Ly; Wanda Phipatanakul; Kristie R Ross; Joe Zein; Nizar N Jarjour Journal: J Allergy Clin Immunol Date: 2019-10-08 Impact factor: 10.793