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Plaza Moral V, Alobid I, Álvarez Rodríguez C, Blanco Aparicio M, Ferreira J, García G, Gómez-Outes A, Garín Escrivá N, Gómez Ruiz F, Hidalgo Requena A, Korta Murua J, Molina París J, Pellegrini Belinchón FJ, Plaza Zamora J, Praena Crespo M, Quirce Gancedo S, Sanz Ortega J, Soto Campos JG. GEMA 5.3. Spanish Guideline on the Management of Asthma. OPEN RESPIRATORY ARCHIVES 2023; 5:100277. [PMID: 37886027 PMCID: PMC10598226 DOI: 10.1016/j.opresp.2023.100277] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2023] Open
Abstract
The Spanish Guideline on the Management of Asthma, better known by its acronym in Spanish GEMA, has been available for more than 20 years. Twenty-one scientific societies or related groups both from Spain and internationally have participated in the preparation and development of the updated edition of GEMA, which in fact has been currently positioned as the reference guide on asthma in the Spanish language worldwide. Its objective is to prevent and improve the clinical situation of people with asthma by increasing the knowledge of healthcare professionals involved in their care. Its purpose is to convert scientific evidence into simple and easy-to-follow practical recommendations. Therefore, it is not a monograph that brings together all the scientific knowledge about the disease, but rather a brief document with the essentials, designed to be applied quickly in routine clinical practice. The guidelines are necessarily multidisciplinary, developed to be useful and an indispensable tool for physicians of different specialties, as well as nurses and pharmacists. Probably the most outstanding aspects of the guide are the recommendations to: establish the diagnosis of asthma using a sequential algorithm based on objective diagnostic tests; the follow-up of patients, preferably based on the strategy of achieving and maintaining control of the disease; treatment according to the level of severity of asthma, using six steps from least to greatest need of pharmaceutical drugs, and the treatment algorithm for the indication of biologics in patients with severe uncontrolled asthma based on phenotypes. And now, in addition to that, there is a novelty for easy use and follow-up through a computer application based on the chatbot-type conversational artificial intelligence (ia-GEMA).
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Affiliation(s)
| | - Isam Alobid
- Otorrinolaringología, Hospital Clinic de Barcelona, España
| | | | | | - Jorge Ferreira
- Hospital de São Sebastião – CHEDV, Santa Maria da Feira, Portugal
| | | | - Antonio Gómez-Outes
- Farmacología clínica, Agencia Española de Medicamentos y Productos Sanitarios (AEMPS), Madrid, España
| | - Noé Garín Escrivá
- Farmacia Hospitalaria, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | | | | | - Javier Korta Murua
- Neumología Pediátrica, Hospital Universitario Donostia, Donostia-San, Sebastián, España
| | - Jesús Molina París
- Medicina de familia, semFYC, Centro de Salud Francia, Fuenlabrada, Dirección Asistencial Oeste, Madrid, España
| | | | - Javier Plaza Zamora
- Farmacia comunitaria, Farmacia Dr, Javier Plaza Zamora, Mazarrón, Murcia, España
| | | | | | - José Sanz Ortega
- Alergología Pediátrica, Hospital Católico Universitario Casa de Salud, Valencia, España
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Asthma education taught by physical education teachers at grade schools: A randomised cluster trial. Allergol Immunopathol (Madr) 2017; 45:375-386. [PMID: 28318759 DOI: 10.1016/j.aller.2016.10.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 10/31/2016] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Assess whether the Asthma, Sport and Health (ASAH) programme taught by teachers improves asthmatics' quality of life, asthma knowledge, and reduces school absenteeism. DESIGN Randomised cluster trial parallel group. PARTICIPANTS 2293 students (203 asthmatic) in the Intervention School group (IS) and 2214 in the Comparison School (CS) (224 asthmatic) belonging to primary school. INTERVENTION Implementation of the educational programme "Asthma, Sport and Health" at grade schools, taught by physical education teachers. MAIN OUTCOME Quality of life according to the Pediatric Asthma Quality of Life Questionnaire (PAQLQ). SECONDARY OUTCOMES Asthma knowledge, asthma control, school absenteeism. RESULTS After implementing the programme in the IS group, global quality of life improved significantly (p<0.001) as did their domains, symptoms (p<0.001), emotional function (p<0.001) and activity limitations (p<0.01), while in the CS group improvement was seen in global life quality (p<0.01) without any significant changes in the domains for emotional function and activity limitations. Asthma knowledge only increased in IS, among asthmatic students from 16.51 (CI 95% 16.04-16.98) to 18.16 (CI 95% 17.69-18.62) (p<0.001) and students without asthma from 15.49 (CI95% 15.36-15.63) to 17.50 (CI95% 17.36-17.64) (p<0.001). The multiple regression analysis showed that quality of life and its domains depend on asthma knowledge and above all, having well-controlled asthma. We found no decrease in school absenteeism. CONCLUSIONS The ASAH programme improved certain quality of life aspects regarding asthma (emotional function and limitation of activities) and asthma knowledge, but it failed to reduce school absenteeism NCT01607749.
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Flor-Escriche X, Méndez-Gómez J, Poblet-Cortés R, Lamarca-Fornell L, Álvarez-Álvarez S, Davies-Daunas SA. [Quality of life and associated factors in asthma in a Primary Care Center. Application of the reduced version of the Asthma Quality of Life Questionnaire]. Semergen 2016; 42:538-546. [PMID: 26858229 DOI: 10.1016/j.semerg.2015.12.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 12/15/2015] [Accepted: 12/21/2015] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Asthma is a highly prevalent disease that can affect the quality of life (QoL). The objective of this study is to determine the QoL in patients with asthma and its relationship with different factors in a Primary Care centre. MATERIAL AND METHODS A descriptive, cross-sectional study was conducted in an urban health centre. The study included a total of 243 patients between 17 to 70 years who had a diagnosis of asthma in their medical records. The QoL was measured using the Spanish version of the Mini-Asthma Quality of Life Questionnaire, with age, sex, smoking, anxiety, depression, severity and control of asthma as associated variables. RESULTS The mean age was 44.5 years and 71.2% were women. More than half (54.3%) had intermittent asthma, and 45.7% persistent asthma. The overall score in the Mini-Asthma Quality of Life Questionnaire was 5.4 out of 7. The scores by dimensions were: symptoms 5.4; limitation of activities 5.8; emotional function 5.7, and environmental stimuli 4.7. The variables with a worse QoL score that remained statistically significant (P<.05) in the multivariate analysis were poor control of asthma (in all dimensions), history of depression (in all except environmental stimuli), educated to less than secondary level (symptoms and emotional function), and patients admitted to hospital in the past 3 years (symptoms) and who used long-term beta-adrenergics (emotional function). CONCLUSIONS Patients with intermittent, mild and moderate asthma have a good QoL. Poor control of the asthma and a history of depression negatively affect the QoL.
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Affiliation(s)
- X Flor-Escriche
- Medicina Familiar y Comunitaria, Centro de Salud Chafarinas, Unidad Docente de Medicina Familiar y Comunitaria de Barcelona Ciudad, Institut Català de la Salut, Barcelona, España
| | - J Méndez-Gómez
- Medicina Familiar y Comunitaria, Centro de Salud Chafarinas, Unidad Docente de Medicina Familiar y Comunitaria de Barcelona Ciudad, Institut Català de la Salut, Barcelona, España.
| | - R Poblet-Cortés
- Medicina Familiar y Comunitaria, Centro de Salud Chafarinas, Unidad Docente de Medicina Familiar y Comunitaria de Barcelona Ciudad, Institut Català de la Salut, Barcelona, España
| | - L Lamarca-Fornell
- Medicina Familiar y Comunitaria, Centro de Salud Chafarinas, Unidad Docente de Medicina Familiar y Comunitaria de Barcelona Ciudad, Institut Català de la Salut, Barcelona, España
| | - S Álvarez-Álvarez
- Medicina Familiar y Comunitaria, Centro de Salud Chafarinas, Unidad Docente de Medicina Familiar y Comunitaria de Barcelona Ciudad, Institut Català de la Salut, Barcelona, España
| | - S A Davies-Daunas
- Medicina Familiar y Comunitaria, Centro de Salud Chafarinas, Unidad Docente de Medicina Familiar y Comunitaria de Barcelona Ciudad, Institut Català de la Salut, Barcelona, España
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Uchmanowicz B, Panaszek B, Uchmanowicz I, Rosińczuk J. Clinical factors affecting quality of life of patients with asthma. Patient Prefer Adherence 2016; 10:579-89. [PMID: 27143863 PMCID: PMC4844459 DOI: 10.2147/ppa.s103043] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND In recent years, there has been increased interest in the subjective quality of life (QoL) of patients with bronchial asthma. QoL is a significant indicator guiding the efforts of professionals caring for patients, especially chronically ill ones. The identification of factors affecting the QoL reported by patients, despite their existing condition, is important and useful to provide multidisciplinary care for these patients. AIM To investigate the clinical factors affecting asthma patients' QoL. METHODS The study comprised 100 patients (73 female, 27 male) aged 18-84 years (mean age was 45.7) treated in the Allergy Clinic of the Wroclaw Medical University Department and Clinic of Internal Diseases, Geriatrics and Allergology. All asthma patients meeting the inclusion criteria were invited to participate. Data on sociodemographic and clinical variables were collected. In this study, we used medical record analysis and two questionnaires: the Asthma Quality of Life Questionnaire (AQLQ) to assess the QoL of patients with asthma and the Asthma Control Test to measure asthma control. RESULTS Active smokers were shown to have a significantly lower QoL in the "Symptoms" domain than nonsmokers (P=0.006). QoL was also demonstrated to decrease significantly as the frequency of asthma exacerbations increased (R=-0.231, P=0.022). QoL in the domain "Activity limitation" was shown to increase significantly along with the number of years of smoking (R=0.404; P=0.004). Time from onset and the dominant symptom of asthma significantly negatively affected QoL in the "Activity limitation" domain of the AQLQ (R=-0.316, P=0.001; P=0.029, respectively). QoL scores in the "Emotional function" and "Environmental stimuli" subscale of the AQLQ decreased significantly as time from onset increased (R=-0.200, P=0.046; R=-0.328, P=0.001, respectively). CONCLUSION Patients exhibiting better symptom control have higher QoL scores. Asthma patients' QoL decreases as time from onset increases. A lower QoL is reported by patients who visit allergy clinics more often, and those often hospitalized due to asthma. Smoking also contributes to a lower QoL in asthma patients.
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Affiliation(s)
- Bartosz Uchmanowicz
- Division of Nursing in Internal Medicine Procedures, Department of Clinical Nursing, Wroclaw Medical University, Wroclaw, Poland
| | - Bernard Panaszek
- Department and Clinic of Internal Diseases, Geriatrics and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - Izabella Uchmanowicz
- Division of Nursing in Internal Medicine Procedures, Department of Clinical Nursing, Wroclaw Medical University, Wroclaw, Poland
- Correspondence: Izabella Uchmanowicz, Division of Nursing in Internal Medicine Procedures, Department of Clinical Nursing, Wroclaw Medical University, 5 Bartla Street, Wroclaw 51-618, Poland, Tel +48 71 784 1824, Fax +48 71 345 9324, Email
| | - Joanna Rosińczuk
- Department of Nervous System Diseases, Department of Clinical Nursing, Wroclaw Medical University, Wroclaw, Poland
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