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Living with asthma in Sweden: the ALMA Study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Centrum för klinisk forskning i D län (CKFD).
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2003 (English)In: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 97, no 7, 835-843 p.Article in journal (Refereed) Published
Abstract [en]

Background: Recently performed studies have found a number of limitations in the daily lives of asthmatics, and a large disparity between the perception of the sufferers and what health care professionals believe matters to asthmatics. Aim: What matters to Swedish asthma patients, what medicines do they use, and are they compliant with given prescriptions? A further aim was to compare perceptions about asthma and asthma management in asthmatics and among Swedish general practitioners (GP). Design: A structured telephone interview of a representative sample of Swedish asthmatics, and a mailed questionnaire survey among GPs from different parts of Sweden. Methods: Screening by telephone of a random sample of 10,350 subjects aged 18–45. Of those, 240 were subsequently selected for a detailed structured telephone interview about their asthma. A mailed structured questionnaire containing similar questions to those asked of the asthmatics was sent to 600 GPs, and 139 returned completed answers. Results: 16% of the asthmatics reported (asthma) symptoms occurring every day during the previous month. Nocturnal symptoms at least twice per week were reported by 19%. Both these were reported by considerably higher proportions of the asthmatics than the GPs had expected. A large majority classified their disease as mild or very mild, although great majority reported frequent symptoms. Activities or situations which caused symptoms of asthma often or “now and then” were physical exertion, 67%; bad weather, 59%; contact with animals/pets, 58%; and visits to cafés or restaurants, 36%; and several asthmatics avoided these activities due to their asthma. Conclusion: A great majority of asthmatics report a large number of symptoms and limitations in their daily living in proportions which were roughly expected by the GPs.

Place, publisher, year, edition, pages
2003. Vol. 97, no 7, 835-843 p.
Keyword [en]
Asthma; Living restrictions; Symptoms; Medicines; Epidemiology
National Category
Respiratory Medicine and Allergy
Identifiers
URN: urn:nbn:se:uu:diva-97664DOI: 10.1016/S0954-6111(03)00040-4ISI: 000183882000012PubMedID: 12854635OAI: oai:DiVA.org:uu-97664DiVA: diva2:172692
Available from: 2008-10-30 Created: 2008-10-30 Last updated: 2011-08-09Bibliographically approved
In thesis
1. Asthma in Primary Care: Severity, Treatment and Level of Control
Open this publication in new window or tab >>Asthma in Primary Care: Severity, Treatment and Level of Control
2008 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aims. The overall aim was to examine the severity, treatment and level of control in patients with asthma in primary care in Sweden. The specific aims were to assess what matters to asthma patients, evaluate symptoms, medication and identify factors related to asthma severity, compare the extent of asthma control in 2001 and 2005, and investigate the development of asthma and degree of asthma control in adolescents and young adults who had reported asthma six years earlier.

Methods. The first study was a telephone interview of a representative sample of Swedish asthmatics. In the second study a random sample of 1,136 patients answered two questionnaires. A classification of the asthma severity similar to that in the GINA guidelines was made. In the third study two surveys were performed, in 2001 and in 2005, with a random sample of 1,012 and 224 asthma patients, respectively, and a classification of asthma control similar to the recent GINA guidelines was made. In the fourth study 71 individuals who reported physician-diagnosed asthma in a population-based survey in 1997 and were defined as current asthmatics, were reinvestigated in 2003 with a skin prick test, methacholine challenge test, eucapnic voluntary hyperventilation test and measurement of exhaled nitric oxide.

Results. Common situations causing symptoms of asthma were physical exertion and contact with pets. Nocturnal symptoms were frequent. In primary care 35% of the women and 24% of the men were classified as having severe asthma. Female sex, increasing age, not filling the asthma prescription owing to cost, daily smoking, and pollen allergy increased the odds of having severe asthma. In 2001, 37% had achieved asthma control, as compared with 40% in 2005. Uncontrolled asthma was more common in women and smokers. In the 2003 study of adolescents and young adults with asthma six years earlier, the definition of current asthma was fulfilled by 50 of the 71 subjects and one third had achieved asthma control.

Conclusions. The majority of the asthmatics reported a large number of symptoms and limitations in their daily living. Many asthma patients in primary care have insufficient asthma control. One reason for lack of control might be undertreatment with inhaled corticosteroids.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2008. 76 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 390
Keyword
Adherence, adolescent, adult, asthma, asthma classification, asthma control, asthma severity, compliance, drug therapy, hyperresponsiveness, primary health care, smoking, asthma treatment.
National Category
Family Medicine
Identifiers
urn:nbn:se:uu:diva-9332 (URN)978-91-554-7315-0 (ISBN)
Public defence
2008-11-21, Rudbeckssalen, Rudbecklaboratoriet, Dag Hammarskölds väg 20, Uppsala, 13:15 (English)
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Available from: 2008-10-30 Created: 2008-10-30 Last updated: 2011-05-13Bibliographically approved

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