Temporal Asthma Patterns Using Repeated Questionnaires over 13 Years in a Large French Cohort of Women.

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Temporal Asthma Patterns Using Repeated Questionnaires over 13 Years in a Large French Cohort of Women.

PLoS One. 2013;8(5):e65090

Authors: Sanchez M, Bousquet J, Le Moual N, Jacquemin B, Clavel-Chapelon F, Humbert M, Kauffmann F, Tubert-Bitter P, Varraso R

Abstract
Variable expression is one aspect of the heterogeneity of asthma. We aimed to define a variable pattern, which is relevant in general health epidemiological cohorts. Our objectives were to assess whether: 1) asthma patterns defined using simple asthma questions through repeated measurements could reflect disease variability 2) these patterns may further be classified according to asthma severity/control. Among 70,428 French women, we used seven questionnaires (1992-2005) and a comprehensive reimbursement database (2004-2009) to define three reliable asthma patterns based on repeated positive answers to the ever asthma attack question: “never asthma” (n?=?64,061); “inconsistent” (“yes” followed by “no”, n?=?3,514); “consistent” (fully consistent positive answers, n?=?2,853). The “Inconsistent” pattern was related to both long-term (childhood-onset asthma with remission in adulthood) and short-term (reported asthma attack in the last 12 months, associated with asthma medication) asthma variability, showing that repeated questions are relevant markers of the variable expression of asthma. Furthermore, in this pattern, the number of positive responses (1992-2005) predicted asthma drug consumption in subsequent years, a marker of disease severity. The “Inconsistent” pattern is a phenotype that may capture the variable expression of asthma. Repeated answers, even to a simple question, are too often neglected.

PMID: 23741466 [PubMed – in process]

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Biocentury: Regeneron using Interleukin Antibody Receptors for Asthma … – OneMedPlace (blog)

Biocentury: Regeneron using Interleukin Antibody Receptors for Asthma
OneMedPlace (blog)
An estimated 25 million Americans suffer from Asthma, but current medications such as inhalers have been deemed ineffective for 10-20% of its users. Regneron (REGN) and Sanofi (SAN) have partnered to crease a new Asthma drug, Dupilumab. In their
Clearing The Air On The Sanofi-Regeneron Asthma Drug TrialSeeking Alpha

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CLINICAL PHARMACOLOGY STUDY OF A FIXED COMBINATION OF BECLOMETHASONE DIPROPIONATE 50µg PLUS FORMOTEROL FUMARATE 6 µg VERSUS THE FREE COMBINATION OF BECLOMETHASONE HFA pMDI AND FORMOTEROL HFA pMDI AVAILABLE ON THE MARKET USING THE AEROCHAMBER PLUS™ SPACER DEVICE IN ASTHMATIC CHILDREN

Condition:   Asthma
Interventions:   Drug: CHF1535 pMDI + AC Plus;   Drug: BDP and Formoterol + AC Plus
Sponsors:   Chiesi Farmaceutici S.p.A.;   Chiesi Farmaceutici S.p.A.
Completed – verified April 2013

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Obamacare Spurs New Thinking On Using the Market to Pay for Prevention – Forbes


India Today

Obamacare Spurs New Thinking On Using the Market to Pay for Prevention
Forbes
And it also is ranked as the second-most polluted city in the country. One result: 17.3 percent of Fresno residents have asthma, more than twice the national average. Every day, 20 asthma sufferers go to the emergency department and three are hospitalized.
Cost, accessibility of health reform act questionedNew Philadelphia Times Reporter

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Only using an asthma inhaler when having an attack is ‘just as effective’ as … – Daily Mail


Daily Mail

Only using an asthma inhaler when having an attack is 'just as effective' as
Daily Mail
'So we wondered what would happen if people with mild asthma already well controlled by daily treatment with an inhaled corticosteroid instead took a puff only when they used their rescue medication – usually albuterol – for relief of symptoms.' His
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Using a knowledge translation framework to implement asthma clinical practice guidelines in primary care.

Using a knowledge translation framework to implement asthma clinical practice guidelines in primary care.

Int J Qual Health Care. 2012 Aug 14;

Authors: Licskai C, Sands T, Ong M, Paolatto L, Nicoletti I

Abstract
Quality problemInternational guidelines establish evidence-based standards for asthma care; however, recommendations are often not implemented and many patients do not meet control targets.Initial assessmentRegional pilot data demonstrated a knowledge-to-practice gap.Choice of solutionsWe engineered health system change in a multi-step approach described by the Canadian Institutes of Health Research knowledge translation framework.ImplementationKnowledge translation occurred at multiple levels: patient, practice and local health system. A regional administrative infrastructure and inter-disciplinary care teams were developed. The key project deliverable was a guideline-based interdisciplinary asthma management program. Six community organizations, 33 primary care physicians and 519 patients participated. The program operating cost was $290/patient.EvaluationSix guideline-based care elements were implemented, including spirometry measurement, asthma controller therapy, a written self-management action plan and general asthma education, including the inhaler device technique, role of medications and environmental control strategies in 93, 95, 86, 100, 97 and 87% of patients, respectively. Of the total patients 66% were adults, 61% were female, the mean age was 35.7 (SD = ±24.2) years. At baseline 42% had two or more symptoms beyond acceptable limits vs. 17% (P< 0.001) post-intervention; 71% reported urgent/emergent healthcare visits at baseline (2.94 visits/year) vs. 45% (1.45 visits/year) (P< 0.001); 39% reported absenteeism (5.0 days/year) vs. 19% (3.0 days/year) (P< 0.001). The mean follow-up interval was 22 (SD = ±7) months.Lessons learnedA knowledge-translation framework can guide multi-level organizational change, facilitate asthma guideline implementation, and improve health outcomes in community primary care practices. Program costs are similar to those of diabetes programs. Program savings offset costs in a ratio of 2.1:1.

PMID: 22893665 [PubMed – as supplied by publisher]

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Athletes with asthma increasing & many may be using wrong medication – ChicagoNow (blog)


ChicagoNow (blog)

Athletes with asthma increasing & many may be using wrong medication
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Oddly, a 2011 study showed that athletes with asthma have out performed those without the condition (since 2000). Additionally, in Great Britain there has been an increase in the number of elite athletes with asthma. The British Medical Journal

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Many Asthmatic Athletes May Not Be Using Best Therapy – Medical News Today

Many Asthmatic Athletes May Not Be Using Best Therapy
Medical News Today
Asthma is an extremely common condition amongst elite athletes; one of whom is marathon runner Paula Radcliffe. Since the 70s, the numbers of athletes suffering from asthma has gradually risen at almost every Olympics, and in 2004, nearly 21% of Team
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Many athletes with asthma may be using the wrong treatment – EurekAlert (press release)

Many athletes with asthma may be using the wrong treatment
EurekAlert (press release)
Many athletes with asthma may not be using the best treatment for their condition and could be putting their long term health at risk, according to a roundup by journalist Sophie Arie published by the BMJ today. The article will feature on the BMJ's

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