Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “ASTHMA”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 541 records · Page 30Linked to original sources
PubMed2004

Indoor allergens, asthma, and asthma-related symptoms among adolescents in Wuhan, China.

PURPOSE: Information on indoor allergen exposures among non-Western populations, which have lower prevalence of atopic illness, is scant. We examined whether exposures to common indoor allergens were associated with doctor-diagnosed asthma and asthma-related symptoms among Chinese adolescents. METHODS: A cross-sectional study of 4,185 ninth grade students was conducted at 22 randomly selected schools in Wuhan, China. Information on respiratory health and exposures to indoor allergens was obtained by a self-administered questionnaire completed in class. RESULTS: Having animals currently was associated with persistent cough [prevalence odds ratio (POR)=1.54, 95% confidence interval (CI ): 1.21-2.11] and wheeze (POR=1.41, 95% CI: 1.03-1.94). Early-life exposure to animals was also associated with doctor-diagnosed asthma (POR=1.95, 95% CI: 1.35-2.82). Associations with respiratory symptoms strengthened with higher levels of exposure and for exposure in both early childhood and in adolescence. Exposure to cockroaches and having mold/water damage in the home contributed especially to wheezing (POR=2.03, 95% CI: 1.41-2.90 for cockroaches; POR=2.49, 95% CI: 1.82-3.40 for mold/water damage). CONCLUSIONS: Indoor allergen exposures were positively associated with asthma diagnosis and persistent respiratory symptoms among Chinese adolescents. Neither early-life nor current exposure to animals was protective for asthma or asthma-related symptoms.

Adolescent↗
PubMed2006

Does early indoor microbial exposure reduce the risk of asthma? The Prevention and Incidence of Asthma and Mite Allergy birth cohort study.

BACKGROUND: Exposure to microbial agents might inhibit the development of atopy and asthma. OBJECTIVE: We measured the association between microbial exposure assessed at 3 months and the development of atopic sensitization and doctor-diagnosed (DD) asthma and wheeze in the first 4 years in a birth cohort study of children with atopic mothers. METHODS: Endotoxin, fungal (1-->3)-beta-D-glucans, extracellular polysaccharides from the genera Penicillium and Aspergillus (EPS-Pen/Asp), and dust on living room floors were measured at 3 months of age. Serum IgE levels against common allergens were determined at 1 and 4 years, and questionnaire information about respiratory morbidity was collected yearly. RESULTS: Microbial levels in mattresses were low and not associated with serum IgE levels, DD asthma, and wheeze. Floor levels of biocontaminants and dust, on the other hand, were inversely associated with DD asthma, being most pronounced for endotoxin (odds ratio [OR], 0.40; 95% CI, 0.21-0.77) and EPS-Pen/Asp (OR, 0.42; 95% CI, 0.18-0.99). Mutual adjustment for other exposures did not significantly alter the results for endotoxin and only moderately affected the results for EPS-Pen/Asp. Persistent wheeze was also consistently less common in the high-exposure group, being significant only for EPS-Pen/Asp (OR, 0.37; 95% CI, 0.15-0.96). Transient wheeze and wheeze in the past 12 months were also reduced, but effects were smaller and not significant. Relationships with serum-specific IgE levels, which could only be assessed in 41% at age 4 years, were less pronounced and statistically significant only for EPS-Pen/Asp. CONCLUSIONS: Early exposure to common microbial contaminants, including fungal agents, might protect against asthma. CLINICAL IMPLICATIONS: Microbial exposure in early life might protect against asthma and might constitute a novel target for prevention.

Allergens↗
PubMed2006

Interrelationships of quantitative asthma-related phenotypes in the Epidemiological Study on the Genetics and Environment of Asthma, Bronchial Hyperresponsiveness, and Atopy.

BACKGROUND: Delineating asthma subphenotypes is of interest to understand the cause of the disease. Few studies have addressed the interrelationships of quantitative asthma-related traits. OBJECTIVE: We sought to study the interrelationships of allergy markers and FEV(1) in relation to asthma and sex in children and adults. METHODS: Total IgE levels, skin prick test (SPT) positivity, eosinophil counts, and FEV(1) were assessed in 299 asthmatic cases (children and adults) recruited in chest clinics and 309 nonasthmatic population-based control subjects in the French Epidemiological Study on the Genetics and Environment of Asthma, Bronchial Hyperresponsiveness, and Atopy. RESULTS: Allergy parameters were significantly higher in asthmatic cases than in control subjects for children and adults and for both sexes. Sex and age modified the pattern of concordance of high IgE levels, SPT positivity, and eosinophilia among asthmatic cases, with the greatest overlap in male children (64%) and the lowest in male adults (18%). Patterns of change over the lifespan of IgE levels, eosinophil counts, and FEV(1)/height(2) varied, with the acceleration of FEV(1) decrease being particularly evident in asthmatic adults. In adult cases and control subjects, SPT positivity (particularly to indoor allergens) was significantly related to IgE levels but not to eosinophil counts. The association of eosinophil counts with IgE levels was evident only in children. Environmental factors (smoking, pets, and country living) did not alter the patterns observed. CONCLUSIONS: Each allergy-related phenotype showed a distinct relation with asthma, with the role for eosinophils being different than that for IgE levels and SPT responses. CLINICAL IMPLICATIONS: Taking age and sex into account is essential for understanding the interrelationships of the various allergy-related phenotypes to asthma status.

Adult↗
PubMed2006

Asthma treatment and asthma prevention: a tale of 2 parallel pathways.

Three recent clinical trials used different study designs to test the hypothesis that early introduction of inhaled corticosteroids in infants and young children at high risk for the development of asthma could change the natural course of the disease. All 3 trials reached the same conclusion: treatment requirement, symptom frequency while off treatment, and lung function did not differ between children receiving active drug or placebo, with outcomes measured 2 to 4 years after randomization. These findings challenge the concept that the inflammatory processes that cause asthma symptoms and are responsive to inhaled corticosteroids are also responsible for the chronic changes in airway structure and function that are believed to predispose to the development of persistent asthma. This conclusion is supported by studies showing that bronchial hyperresponsiveness, independent of current asthma symptoms, is associated with subsequent deficits in airway function growth during childhood. Successful strategies for the prevention of asthma will require a better understanding of the genetic, environmental, and developmental factors that predispose toward inappropriate responses to airway injury. Abnormal airway remodeling and persistent dysregulation of airway tone might be the final common pathway for different disease mechanisms, and this might explain the heterogeneity of clinical phenotypic syndromes that go under the common label of "asthma."

Adrenal Cortex Hormones↗
PubMed2004

Asthma control and steroid doses 5 years after early or delayed introduction of inhaled corticosteroids in asthma: a real-life study.

UNLABELLED: We evaluated asthma control and medication use 5 years after introduction of an inhaled corticosteroid (budesonide via Turbuhaler) in 462 patients with persistent asthma and symptoms of different duration. An early treatment group with symptoms for <2 years (group A) was compared with a delayed treatment group (group B) (median duration 5 years and 3 months). Most patients received budesonide 400 microg twice daily as initial dose. We report 5-year follow-up data on 404 patients (group A n = 253; group B n = 151) and on a few more patients after treatment for 6 months, 1 year and 3 years. At 5 years the mean maintenance doses of budesonide were 412 microg (A) and 825 microg (B), respectively (P<0.001). Nevertheless, treatment goals (normal lung function, normal exercise tolerance, minimal use of reliever medication, no asthma exacerbations) were all statistically significantly more frequently achieved in group A. At 5 years group B patients also used significantly more additional asthma medications, e.g. inhaled long-acting beta2-agonists by 64% compared with 6% in group A. In group A 43 patients (17%) had been able to stop budesonide treatment compared to five patients (3%) in group B. A subgroup of group B patients with higher mean baseline FEV1 values than group A showed nevertheless significantly poorer response. No treatment-related serious adverse events were reported. Budesonide was well tolerated in both groups. CONCLUSION: Duration of asthma symptoms when starting treatment with an inhaled corticosteroid is an important determinant for the response. Early treatment gives significantly better airway function and asthma control than delayed treatment and at lower maintenance doses.

Adolescent↗
PubMed2005

Prevalence of psychiatric morbidity in a difficult asthma population: relationship to asthma outcome.

INTRODUCTION: Psychiatric morbidity appears common in fatal and near-fatal asthma and may be a factor in difficult to control asthmatic subjects. We examined the prevalence of psychiatric morbidity (using psychiatric interview) in a cohort of sequentially referred poorly controlled asthmatics and related this to (a) asthma outcome (b) assessing chest physician opinion and (c) Hospital Anxiety Depression Scale (HADS). METHODS: Patients were evaluated using a systematic evaluation protocol to identify and manage all co-morbidity. Psychiatric assessment was performed by experienced liaison psychiatrists and ICD10 diagnosis and treatment programme assigned. Subjects completed HADS at presentation and follow-up. Asthma was managed according to BTS/SIGN Guidelines. RESULTS: Of 65 subjects who attended for psychiatric interview, 32 (49%) had an ICD10 diagnosis, (6 (9%) previously identified) with depression most common (59%). Physician assessment had poor discrimination for psychiatric illness. Anxiety scores (13.4+/-0.8 vs. 8.5+/-0.7) and depression scores (10.2+/-0.7 vs. 4.8+/-0.5) scores were significantly higher in subjects with ICD10 diagnosis (P<0.001), who were also more likely to be current smokers (P<0.01). HADS had a poor positive predictive value for psychiatric illness but a good negative predictive value for depression. There was no relationship between ICD10 diagnosis and asthma outcome. Subjects identified as therapy-resistant asthma after systematic evaluation, had significantly lower depression scores after treatment (P<0.05). CONCLUSION: In difficult asthmatics, there is a high prevalence of undiagnosed psychiatric morbidity, with depression being particularly prevalent. A simple screening questionnaire such as HADS, has a high false positive rate when compared to psychiatric interview, but may be useful in excluding depressive illness. There appears to be little association between identification and management of co-existent psychiatry morbidity and asthma outcome.

Adult↗
PubMed2005

Identifying 'well-controlled' and 'not well-controlled' asthma using the Asthma Control Questionnaire.

The 7-item Asthma Control Questionnaire (ACQ) has been validated to measure the goals of asthma management as defined by international guidelines (minimisation of day- and night-time symptoms, activity limitation, beta(2)-agonist use and bronchoconstriction). Responses are given on a 7-point scale and the overall score is the mean of the responses (0=totally controlled, 6=severely uncontrolled). The aim of this analysis was to determine the cut-point on the ACQ that best differentiates between 'well-controlled' and 'not well-controlled' for (a) clinical practice (low risk of missing 'not well-controlled') and (b) clinical trials (low risk of including 'well-controlled'). All 1323 patients who provided data sets at week 12 in the Gaining Optimal Asthma Control (GOAL) clinical trial were included in the analysis. The gold standard for 'well-controlled' was a composite based on the GINA/NIH guidelines and derived from data collected in the clinical trial diaries and clinic records. The analysis showed that the crossover point between 'well-controlled' and 'not well-controlled' is close to 1.00 on the ACQ. However, to be confident that a patient has well-controlled asthma, the optimal cut-point is 0.75 (negative predictive value=0.85). To be confident that the patient has inadequately controlled asthma, the optimal cut-point is 1.50 (positive predictive value=0.88). In conclusion, knowledge of these cut-points will enhance practising clinicians ability to identify patients whose asthma requires additional treatment, enable investigators to enroll poorly controlled patients into studies and for both clinicians and investigators to evaluate whether treatment goals are being achieved.

Adolescent↗
PubMed2005

Asthma mortality, inhaled steroids, and changing asthma therapy in Argentina (1990-1999).

BACKGROUND: The asthma managing strategy has evolved and inhaled corticosteroids (ICS) are now the cornerstone of asthma treatment. Their effect on symptoms and exacerbations are well ascertained, whereas their effects on asthma mortality are still matter of debate. This ecological study evaluated asthma mortality rates and drug sales in the decade 1990-1999 in Argentina. METHODS: Mortality (overall and adjusted for 5-34 years) was obtained from the Argentinean Epidemiological Institute, and data on the sales of antiasthma drugs were provided by the International Marketing Survey. RESULTS: There was a significant change in drug sales in the spanned period: ICS +479%, inhaled beta2 agonists +32%, theophylline -63%. The crude and adjusted mortality rates were 3.38 and 0.72 in the 1980-1989 decade, and 2.58 (P<0.05) and 0.38 (P<0.01) in the subsequent one. There was inverse correlation between inhaled corticosteroid sale and age-adjusted (5-34) asthma mortality (r=-0.84; P=0.003), and the same with global mortality rates (r=-0.81; P=0.005). A positive correlation was also seen between theophylline sales and mortality. CONCLUSION: The increased sale of ICS and possibly the decrease of theophylline use seem to be the more relevant factors associated with decreased asthma mortality in Argentina.

Administration, Inhalation↗
PubMed2006

CFTR gene mutations and asthma in the Norwegian Environment and Childhood Asthma study.

BACKGROUND: Several candidate genes have been implicated in the etiology of asthma, including the gene coding for the cystic fibrosis transmembrane conductance regulator (CFTR). Mutations in the CFTR gene result in derangements of mucociliary clearance. Homozygotes for CFTR mutations develop cystic fibrosis (CF), a disorder characterized mainly by lung and pancreas disease. OBJECTIVE: To investigate whether there was an increased frequency of CFTR mutations in asthma patients. METHODS: Seven hundred and three subjects aged 10-11 years from the environment and childhood asthma (ECA) study were included in the present study. Possible associations between asthma, reduced lung function, bronchial hyperresponsiveness (BHR), and increased or decreased nitrogen oxide (NO) levels (based on structural parental interview, spirometry, PD20 methacholine challenge test and exhaled NO measurements), and the five most common CFTR mutations in Norway (DeltaF508, R117H, R117C, 4005+2T-->C, 394delTT), the modulating polymorphisms IVS8(TG)mTn and the IVS8-5T were investigated. RESULTS: No association were found between asthma, reduced lung function, BHR or exhaled NO levels and CF heterozygosity. However, the IVS8(TG)11T7 haplotype was associated with normal lung function. CONCLUSIONS: Our results do not support the hypothesis that CFTR mutations or polymorphisms play a role in the pathogenesis of asthma in children. However, the distribution of Tn(TG)m haplotypes differed between individuals with reduced lung function and individuals with normal lung function.

Asthma↗
PubMed2001

The childhood asthma prevention study (CAPS): design and research protocol of a randomized trial for the primary prevention of asthma.

The Childhood Asthma Prevention Study is a randomized controlled trial to measure whether the incidence of atopy and asthma can be reduced by house dust mite allergen reduction, a diet supplemented with omega-3 fatty acids, or a combination of both interventions. Six hundred and sixteen pregnant women whose unborn children were at high risk of developing asthma because of a family history were randomized prenatally. Study groups are as follows: Group A (placebo diet intervention, no house dust mite reduction), Group B (placebo diet intervention, active house dust mite reduction), Group C (active diet intervention, no house dust mite reduction), and Group D (active diet intervention, active house dust mite reduction). The house dust mite reduction intervention comprises use of physical and chemical methods to reduce allergen contact. The dietary intervention comprises use of a daily oil supplement from 6 months or at onset of bottle-feeding, and use of margarine and cooking oils based on sunflower or canola oils to increase omega-3 dietary intake. Data is collected quarterly until the infant is 1 year old and then half yearly until age 5 years. Questionnaires are used to collect respiratory illness history and information about diet and home environment. Dust is collected from the child's bed and bedroom and playroom floors. Blinded assessments are conducted at 18 months, 3 years, and 5 years. Skin prick tests to common allergens, blood tests, and detailed illness, medication use, and vaccination histories are collected. Primary outcomes will be the development of allergic sensitization and the presence and severity of asthma. This study is designed to measure the effectiveness of allergen reduction and dietary supplementation, both separately and in combination, for the primary prevention of atopy and asthma. The results of this study may have important implications for public health policies to reduce the incidence of childhood asthma. Control Clin Trials 2001;22:333-354

Adult↗
PubMed2001

Asthma leaflets for patients: what do asthma nurses use?

This study investigated patient information leaflets used by trained asthma nurses, and nurses' satisfaction with these. Main outcome measures were frequency of use, sources of material, and rating of reliability and readability. A total of 775 practice nurses with a diploma in asthma working in the general practice setting were surveyed using a postal questionnaire. Forty two percent of questionnaires (326) were returned. The provision of asthma information is an integral part of patient care by the trained asthma nurse. Most nurses (260, 83%) gave out between one and ten leaflets per week. An abundance of diverse information is available from a variety of sources, main sources used were Glaxo-Wellcome (cited by 47% of respondents), National Asthma Campaign (NAC) (19% of respondents) and Astra (19%). Pharmaceutical company material was considered more easily available, free of charge and more attractively presented. NAC material was viewed as more accurate. Assessment of NAC, Glaxo-Wellcome and Astra booklets revealed that they conformed to British Thoracic Society Guidelines for acute asthma. Thus, nurses stated a preference for charity information but in practice used a predominance of pharmaceutical company information. This appears to be because pharmaceutical company information was more readily available and free of charge. Nurses felt unease with self-perceived over-reliance on pharmaceutical company information.

Asthma↗
PubMed1998

The impact of asthma and asthma-like illness in Seattle school children.

The impact of asthma and asthma-like illness was measured in a population of 5-9-year-old Seattle public school children. Child health information was obtained from a survey of 1665 parents of first and second grade students to assess medical services use and impaired physical functioning among diagnosed asthmatics and those with current wheezing, defined as wheezing in the past 12 months without a diagnosis of asthma, relative to an asymptomatic population with neither condition. Relative to the asymptomatic population, the prevalence of respiratory-related activity limitation, and perception of poorer child health was larger among diagnosed asthmatics than children with current wheezing. However, the prevalence of sleep disturbances, school absences, medical services use, and parental concern over their child's health was similar for both the asthmatic and wheezing groups relative to the asymptomatic group. Also, in both symptomatic groups, a history of moderate or severe wheezing was associated with an increased prevalence of respiratory-related sleep disturbances and activity limitation. The similarity between the impact of diagnosed asthma and undiagnosed asthma-like illness suggests that the overall social and economic burden of asthma may be higher than previously estimated.

Absenteeism↗
PubMed2004

[From asthma attack to fatal asthma in children].

Mortality by asthma has decreased, but the number of children being hospitalized is stable: 10% of the asthmatic children are hospitalized within the year, or will be at least once before their tenth year. Some factors are associated with occurrence of a severe asthma attack: poor lung function, bronchial hyperreactivity or poor asthma control, a food allergy, a decreased perception of airway obstruction prior hospitalisation, denial of illness, psychological and social difficulties. The prevention of most asthma exacerbations is possible. The treatment must be adapted to severity of asthma: inhaled steroids, even low doses, have been proven efficient. The follow-up must be regular: planned consultations, repeated lung function testing. Educational programs show an increased quality of life, therapeutic adherence or reduction of hospitalization. The patient and care giver must be able to recognize the signs of severity of asthma exacerbation; an exacerbation is considered severe if it begins suddenly, if its progression or symptoms are unusual, and therefore requires a prompt adapted treatment. An action plan and accessible emergency care are essential.

Administration, Inhalation↗
PubMed1997

Reducing asthma morbidity in the community: the effect of a targeted nurse-run asthma clinic in an English general practice.

Although most primary health care teams in the U.K. now offer proactive care for patients with asthma, there is relatively little published evidence showing the effectiveness of such innovations. This may be due in part to lack of targeting of extra care towards those most in need. Therefore, to demonstrate the benefits of targeted nurse-run asthma clinic care in a seven-partner general practice in a mixed urban and rural area of North Lincolnshire in the east of England, a cohort of 173 patients, with asthma selected predominantly by having high morbidity in a postal survey, completed 12 months follow-up in a nurse-run asthma clinic. A longitudinal comparison was conducted in terms of: changes in morbidity index category, inhaler technique score, knowledge score, use of inhaled steroids, use of salmeterol, method of administration of beta(2)-agonist medication and frequent use of peak flow meters. The number with high morbidity fell from 123 (71.1%) at the initial consultation to 14 (8.1%) at the 12-month review. Those with full marks on inhaler technique rose from 28 (16.2%) to 142 (82.1%), and with full marks on asthma knowledge rose from 7 (4.0%) to 98 (56.6%). The numbers of patients using inhaled steroids and salmeterol rose from 127 (73.4%) to 171 (98.9%) and from 5 (2.9%) to 35 (20.2%), respectively. The preferred inhaler device for beta(2)-bronchodilator medication changed from metered dose aerosol to dry powder. Regular use of peak flow meters in 157 subjects aged 5 years and over rose from 43 (27.4%) to 116 (73.9%). These data clearly demonstrate the benefits of targeted proactive nurse-run asthma care in terms of reduced morbidity for patients. The authors recommend the morbidity index targeting concept to other primary health care teams.

Adolescent↗
PubMed2006

The Inner-City Asthma Intervention asthma counselor program: a collaborative model between physician and social worker to help empower families.

BACKGROUND: The Inner-City Asthma Intervention (ICAI) asthma counselor program was modeled after interventions proven to be effective by the National Cooperative Inner-City Asthma Study (NCICAS) with inner-city children with asthma. The objective of the ICAI program was to translate and implement the NCICAS intervention into the real-world setting. OBJECTIVE: To describe the unique pairing of a master's degree-level social worker asthma counselor (AC) and physician program manager (PM) as they collaborate to implement a successful chronic disease intervention program. METHODS: A case-study design was used to describe the asthma counselor program collaboration at our site. This information was supplemented by additional qualitative data from the final report submitted by the Alliance of Community Health Plans to the Centers for Disease Control and Prevention and from questionnaire data and enrollment and retention data compiled by Wood et al. RESULTS: A master's degree level trained social worker functioned as an AC and successfully collaborated with a physician PM to help combat one of the most common chronic diseases of childhood. This is evident when evaluating administration, recruitment, education and system issues, and community outreach. CONCLUSIONS: The AC/PM partnership is a blueprint of how a successful collaboration may be duplicated by future social worker-physician teams. An effective program needs to address administrative issues, patient recruitment, ongoing team education, patient retention, and community outreach. Practical examples of each element are described.

Asthma↗
PubMed2004

Measuring asthma disparities in Hispanics: adherence to the national guidelines for asthma treatment in emergency departments in Puerto Rico.

BACKGROUND: Puerto Rico has the highest prevalence of asthma in the United States. Currently, there are no data on actual care given to asthmatic patients. OBJECTIVE: To determine the prevalence of documented adherence to the 1997 National Asthma Education Prevention Program guidelines regarding care given in emergency departments (EDs) in Ponce, Puerto Rico. METHODS: A case series was conducted using 6,002 ED records with a physician-based diagnosis of asthma for 1999 through 2001. RESULTS: A history of asthma attack was documented in 82.0% of the cases and in all age groups. In-home beta-agonist use was recorded in only 5.7% of the medical records. Documentation of previous admissions to the ED and the intensive care unit were found in 3.5% and 0.33% of the records, respectively. Nocturnal symptoms before the ED visit were found in only 6.4% of the records, and asthma treatment at home was found in 39.9%. Accessory muscle retraction was documented in 99.1% of the cases, and oxygen saturation was found in 23.2%. Treatment with nebulized beta-agonist was found in 72.1% of the records, and intravenous or oral corticosteroid use was found in 84.1%. Follow-up appointments were detected in 64.8% of the cases, and referrals to specialists were given in only 5.3%. Rate ratios between our data and those of other researchers indicate that there are geographical differences in compliance with the guidelines. CONCLUSION: Of the variables tested, only one had acceptable levels of compliance, as evidenced in the patient's records, indicating that there are alarming differences in ED evaluation and treatment compared with the 1997 National Asthma Education Prevention Program guidelines.

Adolescent↗
PubMed2004

Validity and responsiveness of a brief, asthma-specific quality-of-life instrument in children with acute asthma.

OBJECTIVE: To test the validity and short-term responsiveness to change of a pediatric, asthma-specific, health-related quality-of-life (HRQL) instrument. METHODS: Children 2 years and older treated in the emergency department (ED) for acute asthma were eligible for this prospective cohort study. A 10-item instrument, the Integrated Therapeutics Group Child Asthma Short Form (ITG-CASF), was administered at the time of the ED visit and again 14 days later (via telephone). At the follow-up call, parents were also asked about the child's current overall asthma status, missed school or limited activities, and persistence of asthma symptoms. RESULTS: A total of 121 children were enrolled (mean age, 7.9 years), and follow-up was complete for 96 (79%). Mean +/- SD ITG-CASF scores at follow-up were significantly higher among children reported to have improved overall (61.8 +/- 19.6) than those not improved (41.9 +/- 21.2), and there was a significant correlation between ITG-CASF score at follow-up and the number of days of school missed or limited activities (r = -0.45; 95% confidence interval [CI], -0.24 to -0.66). There was also a significant difference in improvement in ITG-CASF score from ED visit to follow-up among those improved (13.7-point improvement) compared with those not improved (3.3-point improvement; difference = 10.4; 95% CI, 1.2 to 19.5). The effect size was 0.68, indicating a large responsiveness to change. CONCLUSIONS: The ITG-CASF is a valid and responsive measure of HRQL in children with acute asthma and may be a useful outcome measure in evaluating ED treatment.

Acute Disease↗
PubMed2001

Clinical health education for patients with asthma-like symptoms but negative asthma tests.

BACKGROUND: Patients with asthma-like symptoms but negative asthma tests often state that they lack strategies to cope with their symptoms. The aim of the study was to determine whether a problem-based health education program had a beneficial effect on the participants' experience of symptoms and subjective health. METHODS: Thirty-eight patients, consecutively drawn from an outpatient clinic for asthma and allergy, were randomly allocated to an intervention group (I group, n=18) and a control group (C group, n=20). The I group, divided into three subgroups, met on seven occasions over 5 months. The program had a multidisciplinary approach, used exercises inspired by cognitive behavioral therapy, and was performed according to the principles of problem-based learning. All patients answered the Nijmegen Symptom Questionnaire (NQ) and the SF-36 health survey before and 2 months after the training was terminated. RESULTS: Before the program, there were no significant differences between the groups in their earlier experience of symptoms. After it, the I group scored significantly lower on shortness of breath (P=0.001) and central tetany (P=0.05) than the C group. On both test occasions, the asthma-like patients scored lower on all variables of the SF-36 than the reference groups of asthmatics and healthy subjects. No significant differences were seen between the I group and the C group except for vitality, in which the C group scored lower before the intervention. CONCLUSIONS: Patients with asthma-like symptoms but negative asthma tests benefit from taking part in a problem-based health education program. It mainly reduces the frequency of symptoms.

Adult↗