Specific comorbidities and low adherence are independent risk factors for poorer asthma control and exacerbations in patients with difficult-to-control asthma

Introduction: Comorbidities and poor adherence are common features in patients with difficult-to-control asthma. However, the relative effect of these parameters on asthma control and exacerbations is less investigated.Aim: To examine the impact of comorbidities, poor inhaler technique and adherence on asthma control and frequent exacerbations in a representative cohort of patients with difficult-to-control asthma.Methods: All adult asthma patients (n=1034) seen in four respiratory clinics over one year were screened prospectively for asthma severity. Patients with difficult-to-control asthma according to ERS/ATS criteria (high-dose inhaled/oral corticosteroids) (n=117) underwent systematic assessment to identify adherence, inhaler technique and comorbidities (dysfunctional breathing (DB), obesity (BMI), chronic rhinosinuitis (CRS), obstructive sleep apnea, anxiety-depression). Asthma control was evaluated by using asthma control questionnaire (ACQ). Multivariate regression models were adjusted for blood eosinophil countsResults: In multivariate regression analysis, DB (b (95CI): 1.30 (0.90; 1.69) p
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Monitoring airway disease Source Type: research

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Source: Expert Review of Anti-Infective Therapy - Category: Infectious Diseases Tags: Expert Rev Anti Infect Ther Source Type: research
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Source: Expert Opinion on Pharmacotherapy - Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research
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Source: Der Nervenarzt - Category: Neurology Authors: Tags: Nervenarzt Source Type: research
Purpose of review Severe asthma is often associated with numerous comorbidities that complicate disease management and affect patient's outcomes. They contribute to poor disease control and mimic asthma symptoms. Although some comorbidities such as obstructive sleep apnea, bronchiectasis, and chronic obstructive pulmonary disease are generally well recognized, many other may remain undiagnosed but may be detected in an expert specialist setting. The management of comorbidities seems to improve asthma outcomes, and optimizes therapy by avoiding overtreatment. The present review provides recent knowledge regarding the most...
Source: Current Opinion in Pulmonary Medicine - Category: Respiratory Medicine Tags: ASTHMA: Edited by Nicola A. Hanania, Zuzana Diamant, and Maarten van den Berge Source Type: research
Poor control in patients with difficult-to-treat asthma might be due to several factors, including poor adherence and undertreated asthma co-morbidities. After an assessment addressing these issues, only few patients still need targeted therapy.We aimed to evaluate the effect of a multidimensional intervention in improvement asthma control in patients with difficult asthma.Fifty patients with difficult asthma were prospectively included in this study conducted in AbderrahmenMami hospital between March 2018 and September 2018. Clinical, biological and functional characteristics were collected. Then, coexisting conditions (p...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Airway pharmacology and treatment Source Type: research
Obese adults with asthma have an increased number of comorbidities and reduced daily life physical activity (DLPA), which may worsen asthma symptoms. Exercise is recommended to improve asthma outcomes; however, the benefits of exercise for psychosocial comorbidities and DLPA have been poorly investigated.Aim: To assess the effects of exercise on DLPA, asthma symptoms and psychosocial comorbidities in obese adults with asthma.Methods: 55 obese asthmatics were randomly assigned to either a weight-loss program+exercise (WL+E group) or a weight-loss program+sham (WL+S group) (2xW for 3 months). DLPA (GT3X accelerometer), asthm...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Rehabilitation and Chronic Care Source Type: research
This study aimed to assess the effects of exercise on DLPA, asthma symptoms, and psychosocial comorbidities in obese adults with asthma. Methods Fifty-five grade II obese adults with asthma were randomly assigned to either a weight loss program + exercise program (WL + E group, n = 28) or a weight loss program + sham (WL + S group, n = 27). The WL + E group incorporated aerobic and resistance muscle training into the weight loss program (nutrition and psychological therapies), whereas the WL + S group performed breathing and stretching exercises. DLPA, asthma symptoms, sleep quality, and anxiety and depression symptoms ...
Source: Medicine and Science in Sports and Exercise - Category: Sports Medicine Tags: Clinical Sciences Source Type: research
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Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news
Background: Obese asthmatics have more symptoms, impairment in quality of life, higher levels of anxiety and depression, reduced daily life physical activities (DLPA) and sleep disorders. Weight-loss is known to improve asthma control; however the role of exercise training to reduce psychological distress and sleep quality remains unknown. Aim: To assess the effect of exercise training in a weight-loss program on psychosocial morbidity, sleep quality, and DLPA in obese asthmatics.Methods: 55 obese clinically stable asthmatics wererandomly assigned to either weight-loss program+exercise (WL+E group) (2xweek for 3 months) or...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: 1.2 Rehabilitation and Chronic Care Source Type: research
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