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Saito H, Tsuchiya K, Chiba S, Ogata T, Imase R, Yagi T, Mishima Y, Jinta T, Saito K, Taki R, Isogai S, Jin Y, Kawasaki T, Natsume I, Miyashita Y, Takagiwa J, Ishiwata N, Chiaki T, Kishi M, Tsukada Y, Yamasaki M, Inase N, Miyazaki Y. Treatment of asthma in smokers: A questionnaire survey in Japanese clinical practice. Respir Investig 2018; 57:126-132. [PMID: 30552072 DOI: 10.1016/j.resinv.2018.11.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 11/06/2018] [Accepted: 11/13/2018] [Indexed: 01/28/2023]
Abstract
BACKGROUND Cigarette smoking in patients with asthma leads to poor symptom control. As patients who are current smokers have been excluded from enrollment in many clinical trials on asthma, there are few reports on the treatment in current smokers with asthma. In this study, we aimed to assess how respiratory physicians manage asthma in current smokers in Japan. METHODS Respiratory physicians in 16 Japanese hospitals answered a questionnaire on treatment for patients with asthma between December 2014 and February 2015. Medical records were reviewed for 1756 patients with asthma. RESULTS The mean patient age was 61.1 years, and 62.9% of the patients were female. A total of 102 patients (5.8%) were current smokers, and 546 patients (31.1%) were former smokers. Long-acting muscarinic antagonists (LAMA) were prescribed more frequently for current smokers with asthma than for former smokers and never smokers with asthma (10.8% vs 4.6%, p = 0.01, 10.8% vs 3.8%, p < 0.01). In contrast, macrolides were prescribed more frequently for former smokers and never smokers with asthma than for current smokers with asthma (7.7% vs 1.0%, p = 0.01, 6.4% vs 1.0%, p = 0.03). Triple therapy, i.e., inhaled corticosteroids, long-acting beta agonists, and LAMA concomitantly, was prescribed for current smokers with asthma more frequently than for former smokers and never smokers with asthma (9.8% vs 4.0%, p = 0.01, 9.8% vs 3.3%, p < 0.01). CONCLUSIONS According to this survey, current smokers with asthma received more intensive therapy, including LAMA, than did former smokers with asthma.
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Affiliation(s)
- Hiroaki Saito
- Department of Respiratory Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.
| | - Kimitake Tsuchiya
- Department of Respiratory Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.
| | - Sahoko Chiba
- Department of Respiratory Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.
| | - Tomoyuki Ogata
- Department of Respiratory Medicine, JA Toride Medical Center, 2-1-1 Hongo, Toride-shi, Ibaraki 302-0022, Japan.
| | - Reina Imase
- Department of Respiratory Medicine, JA Toride Medical Center, 2-1-1 Hongo, Toride-shi, Ibaraki 302-0022, Japan.
| | - Tamon Yagi
- Department of Respiratory Medicine, JA Toride Medical Center, 2-1-1 Hongo, Toride-shi, Ibaraki 302-0022, Japan.
| | - Yuka Mishima
- Department of Respiratory Medicine, JA Toride Medical Center, 2-1-1 Hongo, Toride-shi, Ibaraki 302-0022, Japan.
| | - Torahiko Jinta
- Department of Respiratory Medicine, St. Luke׳s International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo 104-8560, Japan.
| | - Kazuhito Saito
- Department of Respiratory Medicine, Tsuchiura Kyodo General Hospital, 4-1-1 Otsuno, Tsuchiura-shi, Ibaraki 300-0028, Japan.
| | - Reiko Taki
- Department of Respiratory Medicine, Japanese Red Cross Musashino Hospital, 1-26-1 Kyonancho, Musashino-shi, Tokyo 180-8610, Japan.
| | - Susumu Isogai
- Department of Respiratory Medicine, Ome Municipal General Hospital, 4-16-5 Higashiome, Ome-shi, Tokyo 198-0042, Japan.
| | - Yasuto Jin
- Department of Respiratory Medicine, Hiratsuka Kyosai Hospital, 9-11 Oiwake, Hiratsuka-shi, Kanagawa 254-8502, Japan.
| | - Tsutomu Kawasaki
- Department of Respiratory Medicine, Yokohama City Minato Red Cross Hospital, 3-12-1 Shinyamashita, Naka-ku, Yokohama-shi, Kanagawa 231-8682, Japan.
| | - Ichiro Natsume
- Department of Respiratory Medicine, Yokosuka Kyosai Hospital, 1-16 Yonegahama-dori, Yokosuka-shi, Kanagawa 238-8558, Japan.
| | - Yoshihiro Miyashita
- Department of Respiratory Medicine, Yamanashi Prefectural Central Hospital, 1-1-1 Fujimi, Kofu-shi, Yamanashi 400-8506, Japan.
| | - Jun Takagiwa
- Department of Respiratory Medicine, Tokyo Kyosai Hospital, 2-3-8 Nakameguro, Meguro-ku, Tokyo 153-8934, Japan.
| | - Nobuo Ishiwata
- Internal Medicine, Kudanzaka Hospital, 1-6-12 Kudanminami, Chiyoda-ku, Tokyo 102-0074, Japan.
| | - Tomoshige Chiaki
- Department of Respiratory Medicine, Hokushin General Hospital, 1-5-63 Nishi, Nakano-shi, Nagano 383-8505, Japan.
| | - Masato Kishi
- Department of Respiratory Medicine, Mishima General Hospital, 2276 Aza-fujikubo, Yata, Mishima-shi, Shizuoka 411-0801, Japan.
| | - Yoshikazu Tsukada
- Department of Respiratory Medicine, Soka Municipal Hospital, 2-21-1 Soka, Soka-shi, Saitama 340-8560, Japan.
| | - Motohisa Yamasaki
- Department of Respiratory Medicine, Nitobe Memorial Nakano General Hospital, 4-59-16 Chuo, Nakano-ku, Tokyo 164-8607, Japan.
| | - Naohiko Inase
- Department of Respiratory Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.
| | - Yasunari Miyazaki
- Department of Respiratory Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.
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