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Flokstra-de Blok B, Kocks J, Wouters H, Arling C, Chatelier J, Douglass J, Heaney LG, Holmes J, Humbert M, Kolanowski M, Landsman JJA, Lugogo N, Malpass A, Meijer J, Metz B, de Mul B, Postma F, Leving M. Perceptions on Home-Administration of Biologics in the Context of Severe Asthma: An International Qualitative Study. J Allergy Clin Immunol Pract 2022; 10:2312-2323.e2. [PMID: 35487370 DOI: 10.1016/j.jaip.2022.04.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 04/05/2022] [Accepted: 04/11/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Biologics are an effective therapy for severe asthma. Home administration of biologics by patients is likely to facilitate their accessibility. Yet little is known about patients' and health care providers' (HCPs) perceptions regarding home administration of biologics. OBJECTIVE The aim of this study is to create more insight into the perceptions and experiences of patients and HCPs regarding home administration of biologics in the context of the treatment of severe asthma. METHODS A qualitative international study was performed in the Netherlands, United States, Australia, and United Kingdom. In each country, 2 focus groups were held with potential/recent and long-term users of biologics at home. Prior to the focus groups, patients were prompted with themes on online forums. For triangulation purposes, interviews were held with HCPs to discuss salient findings from forums and focus groups. Data were analyzed with qualitative content analysis. RESULTS In total, 75 patients participated in the forums, of which 40 participated in the focus groups. Furthermore, 12 HCPs were interviewed. The following overarching themes were identified: living with severe asthma; practical aspects of using biologics; the role of HCPs regarding biologics; social support from family, friends, and others; effectiveness of biologics and other treatments; side effects of biologics. CONCLUSIONS This study showed that, for those using biologics for severe asthma, the benefits of home administration of biologics usually outweigh inconvenience and side effects. Guided practice, accessible support contact, and monitoring including social support should be central in the transition from hospital to home administration of asthma biologics.
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Affiliation(s)
- Bertine Flokstra-de Blok
- General Practitioners Research Institute, Groningen, The Netherlands; Groningen Research Institute Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Department of Pediatric Pulmonology and Pediatric Allergology, University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Groningen, The Netherlands.
| | - Janwillem Kocks
- General Practitioners Research Institute, Groningen, The Netherlands; Groningen Research Institute Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Observational and Pragmatic Research Institute, Singapore, Singapore; Department of Pulmonology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Hans Wouters
- General Practitioners Research Institute, Groningen, The Netherlands
| | - Chantal Arling
- General Practitioners Research Institute, Groningen, The Netherlands
| | - Josh Chatelier
- Department of Medicine, The Royal Melbourne Hospital, University of Melbourne, Parkville, Australia
| | - Jo Douglass
- Department of Medicine, The Royal Melbourne Hospital, University of Melbourne, Parkville, Australia
| | - Liam G Heaney
- Wellcome Wolfson Centre for Experimental Medicine, Queens University, Belfast, Northern Ireland
| | - Joshua Holmes
- Wellcome Wolfson Centre for Experimental Medicine, Queens University, Belfast, Northern Ireland
| | - Marc Humbert
- Faculty of Medicine, Université Paris-Saclay, INSERM UMR_S 999, Assistance Publique - Hôpitaux de Paris, Department of Respiratory and Intensive Care Medicine, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Mary Kolanowski
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, Mich
| | - Jeanet J A Landsman
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Njira Lugogo
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, Mich
| | - Alice Malpass
- Bristol Medical School, Centre for Academic Primary Care (CAPC), University of Bristol, Bristol, UK
| | - Jiska Meijer
- General Practitioners Research Institute, Groningen, The Netherlands
| | - Boyd Metz
- General Practitioners Research Institute, Groningen, The Netherlands
| | - Bibicha de Mul
- General Practitioners Research Institute, Groningen, The Netherlands
| | - Frank Postma
- General Practitioners Research Institute, Groningen, The Netherlands
| | - Marika Leving
- General Practitioners Research Institute, Groningen, The Netherlands
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Houwing DJ, Schuttel K, Struik EL, Arling C, Ramsteijn AS, Heinla I, Olivier JDA. Perinatal fluoxetine treatment and dams' early life stress history alter affective behavior in rat offspring depending on serotonin transporter genotype and sex. Behav Brain Res 2020; 392:112657. [PMID: 32339551 DOI: 10.1016/j.bbr.2020.112657] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 04/08/2020] [Accepted: 04/14/2020] [Indexed: 01/06/2023]
Abstract
Many women diagnosed with a major depression continue or initiate antidepressant treatment during pregnancy. Both maternal stress and selective serotonin inhibitor (SSRI) antidepressant treatment during pregnancy have been associated with changes in offspring behavior, including increased anxiety and depressive-like behavior. Our aim was to investigate the effects of the SSRI fluoxetine (FLX), with and without the presence of a maternal depression, on affective behavior in male and female rat offspring. As reduced serotonin transporter (SERT) availability has been associated with altered behavioral outcome, both offspring with normal (SERT+/+) and reduced (SERT+/-) SERT expression were included. For our animal model of maternal depression, SERT+/- dams exposed to early life stress were used. Perinatal FLX treatment and early life stress in dams (ELSD) had sex- and genotype-specific effects on affective behavior in the offspring. In female offspring, perinatal FLX exposure interacted with SERT genotype to increase anxiety and depressive-like behavior in SERT+/+, but not SERT+/-, females. In male offspring, ELSD reduced anxiety and interacted with SERT genotype to decrease depressive-like behavior in SERT+/-, but not SERT+/+, males. Altogether, SERT+/+ female offspring appear to be more sensitive than SERT+/- females to the effects of perinatal FLX exposure, while SERT+/- male offspring appear more sensitive than SERT+/+ males to the effects of ELSD on affective behavior. Our data suggest a role for offspring SERT genotype and sex in FLX and ELSD-induced effects on affective behavior, thereby contributing to our understanding of the effects of perinatal SSRI treatment on offspring behavior later in life.
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Affiliation(s)
- Danielle J Houwing
- Department of Neurobiology, GELIFES, University of Groningen, Nijenborgh 7, 9747 AG Groningen, The Netherlands
| | - Kirsten Schuttel
- Department of Neurobiology, GELIFES, University of Groningen, Nijenborgh 7, 9747 AG Groningen, The Netherlands
| | - Eline L Struik
- Department of Neurobiology, GELIFES, University of Groningen, Nijenborgh 7, 9747 AG Groningen, The Netherlands
| | - Chantal Arling
- Department of Neurobiology, GELIFES, University of Groningen, Nijenborgh 7, 9747 AG Groningen, The Netherlands
| | - Anouschka S Ramsteijn
- Department of Neurobiology, GELIFES, University of Groningen, Nijenborgh 7, 9747 AG Groningen, The Netherlands
| | - I Heinla
- Department of Psychology, UiT The Arctic University of Norway, Hansine Hansens veg 18, 9019 Tromsø, Norway
| | - Jocelien D A Olivier
- Department of Neurobiology, GELIFES, University of Groningen, Nijenborgh 7, 9747 AG Groningen, The Netherlands.
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