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Asthma control in Europe: a real-world evaluation based on an international population-based study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
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2007 (English)In: Journal of Allergy and Clinical Immunology, ISSN 0091-6749, E-ISSN 1097-6825, Vol. 120, no 6, 1360-1367 p.Article in journal (Refereed) Published
Abstract [en]

Background: Epidemiologic evidence related to asthma control in   patients from the general population is scanty.

Objectives: We sought to assess asthma control in several European   centers according to the Global Initiative for Asthma (GINA) guidelines   and to investigate its determinants.

Methods: In the European Community Respiratory Health Survey 11   (1999-2002), 1241 adults with asthma were identified and classified   into inhaled corticosteroid (ICS) users and non-ICS users in the last   year. Control was assessed in both groups by using the GINA proposal   (controlled, partly controlled, and uncontrolled asthma), and it was   related to potential determinants.

Results: Only 15% (95% CI, 12% to 19%) of subjects who had used ICSs in   the last year and 45% (95% CI, 41% to 50%) of non-ICS users had their   asthma under control; individuals with uncontrolled asthma accounted   for 49% (95% CI, 44% to 53%) and 18% (95% CI, 15% to 21%),   respectively. Among ICS users, the prevalence of uncontrolled asthma   showed great variability across Europe, ranging from 20% (95% CI, 7% to   41%; Iceland) to 67% (95% CI, 35% to 90%; Italy). Overweight status, chronic cough and phlegm, and sensitization to Cladosporium species   were associated with poor control in ICS users. About 65% and 87% of   ICS users with uncontrolled and partly controlled asthma, respectively,   were on a medication regimen that was less than recommended by the GINA   guidelines. Conclusion: Six of 7 European asthmatic adults using ICSs in the last   year did not achieve good disease control. The large majority of   subjects with poorly controlled asthma were using antiasthma drugs in a   suboptimal way. A wide variability in asthma control emerged across   Europe.

Clinical implications: Greater attention should be paid to asthma management and to the implementation of the GINA guidelines.

Place, publisher, year, edition, pages
2007. Vol. 120, no 6, 1360-1367 p.
Keyword [en]
Adult, Allergens/adverse effects, Animals, Asthma/diagnosis/*drug therapy/*epidemiology, Cross-Sectional Studies, Disease Management, European Union, Female, Humans, Male, Practice Guidelines as Topic/standards, Prevalence, Questionnaires, Randomized Controlled Trials as Topic, Risk Factors, Severity of Illness Index
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-16769DOI: 10.1016/j.jaci.2007.09.019ISI: 000251653800017PubMedID: 17981317OAI: oai:DiVA.org:uu-16769DiVA: diva2:44540
Available from: 2008-06-04 Created: 2008-06-04 Last updated: 2010-05-03Bibliographically approved

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