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Soong W, Chipps BE, Carr W, Trevor J, Patel A, Clarke N, Carstens DD, Ambrose CS. Quality of Life Improvements with Biologic Initiation Among Subspecialist-Treated US Patients with Severe Asthma. J Asthma Allergy 2024; 17:441-448. [PMID: 38745837 PMCID: PMC11093117 DOI: 10.2147/jaa.s452386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 04/17/2024] [Indexed: 05/16/2024] Open
Abstract
Purpose Patients living with severe asthma (SA) experience multiple health-related quality of life (HRQoL) impairments. This study examined HRQoL changes after biologic treatment initiation among a large, real-world cohort of patients with SA. Patients and methods CHRONICLE is an ongoing observational study of subspecialist-treated adults with SA who receive biologics or maintenance systemic corticosteroids or are uncontrolled on high-dosage inhaled corticosteroids with additional controllers. Patients enrolled February 2018-February 2023 were asked to complete the St. George's Respiratory Questionnaire (SGRQ) every 6 months (total score range of 0-100 [0=best possible health], meaningful change threshold is a 4-unit reduction in the total score). Changes in SGRQ responses from 6 months before initiation to 12 to 18 months after initiation were summarized. Results A total of 76 patients completed the SGRQ 0 to 6 months before and 12 to 18 months after biologic initiation. The mean (SD) SGRQ total score decreased from 52.2 (20.6) to 41.9 (23.8), with improvement across the symptoms (-14.5), activity (-11.0), and impacts (-8.3) components. For specific impairments reported by ≥50% of patients before biologic initiation, fewer reported each impairment after biologic initiation; the largest reductions were for "Questions about what activities usually make you feel short of breath these days [Walking outside on level ground]" (67% to 43%), "Questions about other effects that your respiratory problems may have on you these days [I feel that I am not in control of my respiratory problems]" (55% to 34%), and "Questions about your cough and shortness of breath these days [My coughing or breathing disturbs my sleep]" (63% to 45%). Conclusion In this real-world cohort of adults with SA, biologic initiation was associated with meaningful improvements in asthma-related HRQoL. These data provide further insight into the burden SA places on patients and the benefits of biologic treatment.
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Affiliation(s)
- Weily Soong
- AllerVie Health, AllerVie Clinical Research, Birmingham, AL, USA
| | - Bradley E Chipps
- Capital Allergy & Respiratory Disease Center, Sacramento, CA, USA
| | - Warner Carr
- Allergy & Asthma Associates of Southern California, Food Allergy Center of Southern California, Mission Viejo, CA, USA
| | - Jennifer Trevor
- Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Arpan Patel
- BioPharmaceuticals Medical, AstraZeneca, Wilmington, DE, USA
| | - Nicole Clarke
- BioPharmaceuticals Medical, AstraZeneca, Gaithersburg, MD, USA
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2
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Leso V, Candia C, Pacella D, Molino A, Nocera C, Maniscalco M, Iavicoli I. Quality of life and work functionality in severe asthma patients: the impact of biological therapies. J Occup Med Toxicol 2024; 19:8. [PMID: 38509562 PMCID: PMC10953125 DOI: 10.1186/s12995-024-00406-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 02/28/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Severe asthma can cause poor health status, poor health-related quality of life (HRQoL) and an impaired functioning at work. However, to date, limited data are available on the impact of the biological therapies on such outcomes. Therefore, aim of the present study was to prospectively assess the clinical, quality of life and work functionality issues in severe asthma patients both at baseline and after 6 months of biological therapies and determine which individual, pathological and occupational factors can influence such parameters. METHODS Fifty-two patients were enrolled between December 2022 and June 2023. Patients' personal, clinical, functional and occupational features were assessed. The Short Form Health Survey (SF-12), the Work Productivity and Activity Impairment (WPAI) questionnaire and the Work Ability Index (WAI) were employed to assess HRQoL, the employee's productivity and perception of work ability, respectively. RESULTS Among the enrolled patients, 30 (57.70%) were employed. Biological therapy induced a significant improvement in clinical and functional parameters, e.g., FEV1% (72 ± 12 vs.87 ± 13%; 72 ± 14 vs. 86 ± 14%), FVC% (92 ± 11 vs. 101 ± 11%; 90 ± 13 vs. 98 ± 14%) and FEV1/FVC (62 ± 11 vs. 71 ± 8%; 64 ± 9 vs. 70 ± 8%) in workers and non-workers, respectively (P < 0.001). Comparably, the perception of life quality significantly improved, as physical and mental health scores, in the overall cohort, increased from 40.7 ± 10.3 and 48.5 ± 8.5 to 46.8 ± 8.6 and 51.6 ± 6.4, respectively (P < 0.001). The work ability perception significantly improved from a moderate to a good one (34 ± 6 vs. 40 ± 6, P = 0.001). A significant reduction in the absenteeism (19 ± 15 vs. 3 ± 11%; P < 0.001) and presenteeism rate (53 ± 24 vs. 29 ± 26%; P < 0.001), and an improvement in daily (40 ± 27.5% vs. 28.9 ± 24.7%, P < 0.001, in the overall population) and work activities (57 ± 25 vs. 29 ± 27%, P < 0.001) was determined. Gender, age, symptoms control and pulmonary functionality were correlated with the physical and mental health perception, daily activity impairment and work ability. CONCLUSIONS Our study pointed out that biological therapies improved clinical, general life and occupational outcomes in patients with severe asthma. The correlation between clinical aspects and psychological and occupational issues suggest the relevance for a multidisciplinary management of the disease for an effective participation of patients in the world of work.
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Affiliation(s)
- Veruscka Leso
- Department of Public Health, Section of Occupational Medicine, University of Naples Federico II, Via S. Pansini 5, Naples, 80131, Italy.
| | - Claudio Candia
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, 80131, Italy
| | - Daniela Pacella
- Department of Public Health, University of Naples Federico II, Via S. Pansini 5, Naples, 80131, Italy
| | - Antonio Molino
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, 80131, Italy
| | - Caterina Nocera
- Department of Public Health, Section of Occupational Medicine, University of Naples Federico II, Via S. Pansini 5, Naples, 80131, Italy
| | - Mauro Maniscalco
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, 80131, Italy
- Pulmonary Rehabilitation Unit of Telese Terme Institute, Istituti Clinici Scientifici Maugeri IRCCS, Telese Terme, 82037, Italy
| | - Ivo Iavicoli
- Department of Public Health, Section of Occupational Medicine, University of Naples Federico II, Via S. Pansini 5, Naples, 80131, Italy
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Rönnebjerg L, Axelsson M, Kankaanranta H, Ekerljung L. Health-related quality of life, anxiety, depression, beliefs of medication, and self-efficacy in individuals with severe asthma - a population-based study. J Asthma 2024; 61:148-159. [PMID: 37610189 DOI: 10.1080/02770903.2023.2248512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 08/08/2023] [Accepted: 08/11/2023] [Indexed: 08/24/2023]
Abstract
OBJECTIVE Individuals with severe asthma often report poor Health-related quality of life (HRQoL) and more research is essential to increase understanding of how they may be helped to improve HRQoL. The main aim of the current paper is to evaluate HRQoL, and possible factors influencing HRQoL, in individuals with severe asthma. The aim is also to explore associations among anxiety, depression, beliefs of medication, self-efficacy, and HRQoL among individuals with severe and other asthma as well as those with no asthma. METHODS Participants with severe asthma (n = 59), other asthma (n = 526), and no asthma (n = 902) were recruited from West Sweden Asthma Study, a population-based study, which includes both questionnaire surveys and clinical examinations. RESULTS Individuals with severe asthma had worse physical HRQoL (measured with SF-8) than those with other and no asthma (median 48.4, 51.9, and 54.3, respectively). They also had worse mental HRQoL (median 46.7) and reported higher anxiety and depression scores (measured using HADS, median 5.0 and 3.5, respectively) compared to no asthma (median 4.0 and 2.0, respectively). HRQoL was particularly affected among women with severe asthma. Individuals with severe asthma believed that their asthma medication was more necessary than those with other asthma, but they reported more concern for the medication. Asthma control and packyears predicted physical HRQoL and anxiety predicted mental HRQoL among individuals with severe asthma. CONCLUSIONS Efforts to improve asthma control and to reduce anxiety may improve HRQoL in individuals with severe asthma. Especially, women with severe asthma seem to need support to improve their HRQoL. Reducing concerns with asthma medication is most likely essential as high concerns may lead to poor adherence, which in turn may negatively affect asthma control and HRQoL.
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Affiliation(s)
- L Rönnebjerg
- Department of Internal Medicine and Clinical Nutrition, Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - M Axelsson
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - H Kankaanranta
- Department of Internal Medicine and Clinical Nutrition, Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Respiratory Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland
- Tampere University Respiratory Research Group, Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland
| | - L Ekerljung
- Department of Internal Medicine and Clinical Nutrition, Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
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Drick N, Brinkmann L, Fuge J, Welte T, Suhling H. Influence of anti-interleukin (IL)-5/anti-IL-5 receptor-α treatment on work productivity in patients with severe eosinophilic asthma. ERJ Open Res 2023; 9:00665-2022. [PMID: 37143840 PMCID: PMC10152247 DOI: 10.1183/23120541.00665-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 02/16/2023] [Indexed: 05/06/2023] Open
Abstract
This retrospective study shows that treatment with anti-eosinophilic antibodies in patients with severe eosinophilic asthma is associated with an increase in work productivity and a decrease in missed days at work https://bit.ly/3IIPppR.
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Affiliation(s)
- Nora Drick
- Dept of Respiratory Medicine, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
- Nora Drick ()
| | - Lina Brinkmann
- Dept of Respiratory Medicine, Hannover Medical School, Hannover, Germany
| | - Jan Fuge
- Dept of Respiratory Medicine, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
| | - Tobias Welte
- Dept of Respiratory Medicine, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
| | - Hendrik Suhling
- Dept of Respiratory Medicine, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
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Haughney J, Winders T, Holmes S, Chanez P, Menzies-Gow A, Kocks J, Mansur AH, McPherson C, Canonica GW. A Charter to Fundamentally Change the Role of Oral Corticosteroids in the Management of Asthma. Adv Ther 2023; 40:2577-2594. [PMID: 37027115 PMCID: PMC10080509 DOI: 10.1007/s12325-023-02479-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 02/21/2023] [Indexed: 04/08/2023]
Abstract
Asthma affects 339 million people worldwide, with an estimated 5-10% experiencing severe asthma. In emergency settings, oral corticosteroids (OCS) can be lifesaving, but acute and long-term treatment can produce clinically important adverse outcomes and increase the risk of mortality. Therefore, global guidelines recommend limiting the use of OCS. Despite the risks, research indicates that 40-60% of people with severe asthma are receiving or have received long-term OCS treatment. Although often perceived as a low-cost option, long-term OCS use can result in significant health impairments and costs owing to adverse outcomes and increased utilization of healthcare resources. Alternative treatment methods, such as biologics, may produce cost-saving benefits with a better safety profile. A comprehensive and concerted effort is necessary to tackle the continued reliance on OCS. Accordingly, a threshold for OCS use should be established to help identify patients at risk of OCS-related adverse outcomes. Receiving a total dose of more than 500 mg per year should trigger a review and specialist referral. Changes to national and local policies, following examples from other chronic diseases, will be crucial to achieving this goal. Globally, multiple barriers to change still exist, but specific steps have been identified to help clinicians reduce reliance on OCS. Implementing these changes will result in positive health outcomes for patients and social and economic benefits for societies.
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Affiliation(s)
- John Haughney
- Glasgow Clinical Research Facility, Queen Elizabeth University Hospital, Glasgow, UK.
| | - Tonya Winders
- Allergy and Asthma Network, Vienna, VA, USA
- Global Allergy and Airways Patient Platform, Vienna, Austria
| | | | - Pascal Chanez
- Department of Respiratory CIC Nord INSERM INRAE C2VN, Aix Marseille University, Marseille, France
| | | | - Janwillem Kocks
- General Practitioners Research Institute, Groningen, The Netherlands
- Observational and Pragmatic Research Institute, Singapore, Singapore
- Groningen Research Institute Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Pulmonology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Adel H Mansur
- Respiratory Medicine, Birmingham Heartlands Hospital and University of Birmingham, Birmingham, UK
| | | | - Giorgio Walter Canonica
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- IRCCS Humanitas Research Hospital, Personalized Medicine, Asthma and Allergy, Milan, Italy
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Bleecker ER, Al-Ahmad M, Bjermer L, Caminati M, Canonica GW, Kaplan A, Papadopoulos NG, Roche N, Ryan D, Tohda Y, Yáñez A, Price D. Systemic corticosteroids in asthma: A call to action from World Allergy Organization and Respiratory Effectiveness Group. World Allergy Organ J 2022; 15:100726. [PMID: 36582404 PMCID: PMC9761384 DOI: 10.1016/j.waojou.2022.100726] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 11/11/2022] [Accepted: 11/18/2022] [Indexed: 12/14/2022] Open
Abstract
Systemic corticosteroids (SCS) are a highly effective treatment for acute exacerbations and long-term symptom control in asthma. Long-term SCS use is highly prevalent across all asthma severities, occurring in over 20% of patients with severe or uncontrolled disease globally. It is now well known that exposure to both long-term and repeated acute courses of SCS is associated with a high risk of serious adverse effects (AEs), such as osteoporosis, and metabolic and cardiovascular complications, especially when prescribed onto a background of other corticosteroids. The aim of this call-to-action article, endorsed by the World Allergy Organization and the Respiratory Effectiveness Group, is to review the accumulating evidence on the burden of SCS on patients with asthma and provide an overview of potential strategies for implementing SCS Stewardship. Primary prevention of exacerbations and improvement of asthma control is a key first step in achieving SCS Stewardship, by optimizing maintenance asthma medications and addressing modifiable risk factors, such as adherence and inhaler technique. Other key elements of SCS Stewardship include increasing appropriate specialist referrals for multidisciplinary review, assessment of biomarkers, and consideration of oral corticosteroid-sparing add-on therapies (eg, biologics). In cases where SCS use is deemed clinically justified, it should be tapered to the lowest possible dose. In addition, patients receiving long-term SCS or frequent acute courses should be closely monitored for emergence of SCS-related AEs. Because of the extensive data available on the costly and burdensome AEs associated with SCS use, as well as the range of treatment options now available, there is a need for healthcare providers (HCPs) to carefully evaluate whether the benefits of SCS outweigh the potential harms, to adopt SCS-sparing and Stewardship strategies, and to consider alternative therapies where possible. Development of a structured and collaborative SCS Stewardship approach is urgently required to protect patients from the potential harm of SCS use.
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Affiliation(s)
- Eugene R. Bleecker
- Division of Genetics, Genomics and Precision Medicine, Department of Medicine, University of Arizona, Tucson, AZ, USA
| | - Mona Al-Ahmad
- Microbiology Department, College of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Leif Bjermer
- Department of Respiratory Medicine and Allergology, University Hospital, Lund, Sweden
| | - Marco Caminati
- Department of Medicine, University of Verona, Verona, Italy
| | - Giorgio Walter Canonica
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center, IRCCS, Rozzano, Italy
| | - Alan Kaplan
- Family Physician Airways Group of Canada, Stouffville, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Nikolaos G. Papadopoulos
- Division of Infection, Immunity & Respiratory Medicine, Royal Manchester Children's Hospital, University of Manchester, Manchester, UK
- Allergy Department, 2nd Pediatric Clinic, Athens General Children's Hospital ‘P&A Kyriakou’, University of Athens, Athens, Greece
| | - Nicolas Roche
- Department of Respiratory Medicine, APHP. Centre Université Paris Cité, Cochin Hospital (AP-HP) and Institute (UMR1016), Paris, France
| | - Dermot Ryan
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Yuji Tohda
- Kindai University Hospital, Osaka, Japan
| | - Anahí Yáñez
- Center for Research on Allergies and Respiratory Diseases (InAER), Buenos Aires, Argentina
| | - David Price
- Observational and Pragmatic Research Institute, Singapore
- Centre of Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
- Corresponding author. Professor David B Price, Observational and Pragmatic Research Institute, 22 Sin Ming Lane, #06 Midview City, Singapore 573969
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Adams S, Rajani M, Baatjies R, Omar F, Jeebhay MF. Health-Related Quality of Life (HRQoL) of Residents with Persistent Lower Respiratory Symptoms or Asthma Following a Sulphur Stockpile Fire Incident. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052915. [PMID: 35270608 PMCID: PMC8910352 DOI: 10.3390/ijerph19052915] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 02/24/2022] [Accepted: 02/26/2022] [Indexed: 12/11/2022]
Abstract
Background: This study evaluated health-related quality of life (HRQoL) in residents with persistent lower respiratory symptoms (PLRS) or asthma six years after exposure to sulphur dioxide vapours emanating from an ignited sulphur stockpile. Methods: A cross-sectional study was carried out, using interview data collected at three time points (prior to, one- and six-years post incident), medical history, respiratory symptoms and HRQOL using the Medical Outcomes Study Form 36 (SF-36). Results: A total of 246 records, 74 with and 172 without PLRS or asthma, were analysed. The mean age was 42 (SD:12) years in the symptomatic group and 41 (SD:13) years in the asymptomatic group. Mean SF-36 scores were significantly lower for the symptomatic group in the Physical Functioning (24 vs. 39), Role—Physical (33 vs. 48) and General Health (GH) domains (24 vs. 37). Symptomatic residents experienced a significant decline in their Role—Physical (OR = 1.97; CI 1.09, 3.55) and GH (OR = 3.50; CI 1.39, 8.79) at year 6 compared to asymptomatic participants. Residents with co-morbid reactive upper airways dysfunction syndrome demonstrated stronger associations for GH (OR = 7.04; CI 1.61, 30.7) at year 1 and at year 6 (OR = 8.58; CI 1.10, 65.02). Conclusions: This study highlights the long-term adverse impact on HRQoL among residents with PLRS or asthma following a sulphur stockpile fire disaster.
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Affiliation(s)
- Shahieda Adams
- Occupational Medicine Division and Centre for Environmental and Occupational Health Research, School of Public Health and Family Medicine, University of Cape Town, Observatory 7925, South Africa; (S.A.); (M.R.); (R.B.); (F.O.)
| | - Mayuri Rajani
- Occupational Medicine Division and Centre for Environmental and Occupational Health Research, School of Public Health and Family Medicine, University of Cape Town, Observatory 7925, South Africa; (S.A.); (M.R.); (R.B.); (F.O.)
| | - Roslynn Baatjies
- Occupational Medicine Division and Centre for Environmental and Occupational Health Research, School of Public Health and Family Medicine, University of Cape Town, Observatory 7925, South Africa; (S.A.); (M.R.); (R.B.); (F.O.)
- Department of Environmental and Occupational Studies, Faculty of Applied Sciences, Cape Peninsula University of Technology (CPUT), Cape Town 7535, South Africa
| | - Faieza Omar
- Occupational Medicine Division and Centre for Environmental and Occupational Health Research, School of Public Health and Family Medicine, University of Cape Town, Observatory 7925, South Africa; (S.A.); (M.R.); (R.B.); (F.O.)
| | - Mohamed Fareed Jeebhay
- Occupational Medicine Division and Centre for Environmental and Occupational Health Research, School of Public Health and Family Medicine, University of Cape Town, Observatory 7925, South Africa; (S.A.); (M.R.); (R.B.); (F.O.)
- Correspondence: ; Tel.: +27-21-4066309
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Menzies-Gow A, Jackson DJ, Al-Ahmad M, Bleecker ER, Cosio Piqueras FDBG, Brunton S, Canonica GW, Chan CKN, Haughney J, Holmes S, Kocks J, Winders T. A Renewed Charter: Key Principles to Improve Patient Care in Severe Asthma. Adv Ther 2022; 39:5307-5326. [PMID: 36251167 PMCID: PMC9573814 DOI: 10.1007/s12325-022-02340-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 09/26/2022] [Indexed: 01/30/2023]
Abstract
Asthma is a heterogenous respiratory disease, usually associated with chronic airway inflammation and hyper-responsiveness, which affects an estimated 339 million people worldwide. Severe asthma affects approximately 5-10% of patients with asthma, approximately 17-34 million people globally, more than half of whom have uncontrolled disease. Severe asthma carries a substantial burden of disease, including unpredictable symptoms and potentially life-threatening flare-ups. Furthermore, severe asthma has a substantial burden on health care systems and economies worldwide. In 2018, a group of experts from the clinical community, patient support groups, and professional organisations joined together to develop the Severe Asthma Patient Charter, which set out six principles to define what patients should expect for the management of their severe asthma and what should constitute a basic standard of care. Since the publication of that original Charter in 2018, several important changes have occurred, including an improved understanding of asthma and effective asthma management; several new therapies have become available; and finally, the COVID-19 pandemic has placed a spotlight on respiratory conditions, the workforces that treat them, and the fundamental importance of health care system resilience. With those developments in mind, we, representatives of the academic, clinical, and patient advocacy group communities, have updated the Charter to Improve Patient Care in Severe Asthma with a focus on six principles: (1) I deserve a timely, comprehensive assessment of my asthma and its severity; (2) I deserve a timely, straightforward referral to an appropriate specialist for my asthma when it is not well controlled; (3) I deserve to understand what makes my asthma worse; (4) I deserve access to treatment and care that reduces the impact of asthma on my daily life; (5) I deserve not to be reliant on systemic corticosteroids; (6) I deserve to be involved in decisions about my treatment and care.
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Affiliation(s)
- Andrew Menzies-Gow
- Royal Brompton and Harefield Hospitals, School of Immunology and Microbial Sciences, King’s College, London, UK ,Department of Respiratory Medicine, Royal Brompton Hospital, Sydney Street, London, SW3 6NP UK
| | - David J. Jackson
- Guy’s Severe Asthma Centre, School of Immunology and Microbial Sciences, King’s College, London, UK
| | - Mona Al-Ahmad
- Microbiology Department, College of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Eugene R. Bleecker
- Department of Medicine, University of Arizona College of Medicine, Tucson, AZ USA
| | | | | | - Giorgio Walter Canonica
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy ,Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Centre IRCCS, Rozzano, Milan Italy
| | | | - John Haughney
- Glasgow Clinical Research Facility, Queen Elizabeth University Hospital, Glasgow, UK
| | | | - Janwillem Kocks
- General Practitioners Research Institute, Groningen, The Netherlands ,Groningen Research Institute Asthma and COPD, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands ,Department of Pulmonology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Tonya Winders
- Allergy and Asthma Network, Vienna, VA USA ,Global Allergy and Airways Patient Platform, Vienna, Austria
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