Adherence with Long-Term Asthma Management in Patients Who Experienced Hospitalized Asthma Exacerbation
Background: In Japan, the number of asthma deaths has been gradually decreasing. However, in the management of asthma, there are still some problems originating from patient-related factors and iatrogenic factors, both of which should be further analyzed. Methods: We investigated clinical and backgr...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2009-01-01
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| Series: | Allergology International |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1323893015307000 |
| _version_ | 1811197742671724544 |
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| author | Kenji Baba Tsutomu Hattori Takeo Yagi Kazuyuki Onoe Seiko Kawai Kazuhito Yoshida Etsuro Yamaguchi |
| author_facet | Kenji Baba Tsutomu Hattori Takeo Yagi Kazuyuki Onoe Seiko Kawai Kazuhito Yoshida Etsuro Yamaguchi |
| author_sort | Kenji Baba |
| collection | DOAJ |
| description | Background: In Japan, the number of asthma deaths has been gradually decreasing. However, in the management of asthma, there are still some problems originating from patient-related factors and iatrogenic factors, both of which should be further analyzed.
Methods: We investigated clinical and background characteristics of 164 patients with asthma who were admitted to our hospital with acute exacerbations, by reviewing their clinical records.
Results: Fifty-two patients had received long-term management (LTM) based on the guidelines (the LTM group), while 112 had not (the non-LTM group). In patients whose asthma severity had been intermittent (step 1), the proportion of severe and near fatal exacerbations was significantly higher in the non-LTM group than in the LTM group. However, even in the LTM-group, 23% of mild persistent (step 2) and 38% of moderately and severely persistent (step 3 & 4) patients had severe or near fatal exacerbations. In these patients, the peak expiratory flow rate significantly improved after discharge, and poor adherence was also significantly higher in the non-LTM group than in the LTM group. A multivariate analysis revealed that the factors associated with poor adherence were: 1) no history of previous admission due to asthma exacerbation; 2) the patient was male; and 3) the patient was young (<60 years).
Conclusions: In the LTM group, re-evaluation of the actual severity of asthma and prompt treatment corresponding to the severity of disease should still be encouraged. In the non-LTM group, establishing countermeasures against factors causing poor adherence would be the next step in ensuring strong adherence with LTM. |
| first_indexed | 2024-04-12T01:18:29Z |
| format | Article |
| id | doaj.art-253a5c4dfba441c4921b591602c8a0cd |
| institution | Directory Open Access Journal |
| issn | 1323-8930 |
| language | English |
| last_indexed | 2024-04-12T01:18:29Z |
| publishDate | 2009-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Allergology International |
| spelling | doaj.art-253a5c4dfba441c4921b591602c8a0cd2022-12-22T03:53:51ZengElsevierAllergology International1323-89302009-01-0158221722410.2332/allergolint.08-OA-0012Adherence with Long-Term Asthma Management in Patients Who Experienced Hospitalized Asthma ExacerbationKenji Baba0Tsutomu Hattori1Takeo Yagi2Kazuyuki Onoe3Seiko Kawai4Kazuhito Yoshida5Etsuro Yamaguchi6Division of Respiratory Medicine and Allergology, Department of Internal Medicine, Aichi Medical University School of Medicine, Aichi, Japan.Division of Respiratory Medicine and Allergology, Department of Internal Medicine, Aichi Medical University School of Medicine, Aichi, Japan.Division of Respiratory Medicine and Allergology, Department of Internal Medicine, Aichi Medical University School of Medicine, Aichi, Japan.Division of Respiratory Medicine and Allergology, Department of Internal Medicine, Aichi Medical University School of Medicine, Aichi, Japan.Division of Respiratory Medicine and Allergology, Department of Internal Medicine, Aichi Medical University School of Medicine, Aichi, Japan.Division of Respiratory Medicine and Allergology, Department of Internal Medicine, Aichi Medical University School of Medicine, Aichi, Japan.Division of Respiratory Medicine and Allergology, Department of Internal Medicine, Aichi Medical University School of Medicine, Aichi, Japan.Background: In Japan, the number of asthma deaths has been gradually decreasing. However, in the management of asthma, there are still some problems originating from patient-related factors and iatrogenic factors, both of which should be further analyzed. Methods: We investigated clinical and background characteristics of 164 patients with asthma who were admitted to our hospital with acute exacerbations, by reviewing their clinical records. Results: Fifty-two patients had received long-term management (LTM) based on the guidelines (the LTM group), while 112 had not (the non-LTM group). In patients whose asthma severity had been intermittent (step 1), the proportion of severe and near fatal exacerbations was significantly higher in the non-LTM group than in the LTM group. However, even in the LTM-group, 23% of mild persistent (step 2) and 38% of moderately and severely persistent (step 3 & 4) patients had severe or near fatal exacerbations. In these patients, the peak expiratory flow rate significantly improved after discharge, and poor adherence was also significantly higher in the non-LTM group than in the LTM group. A multivariate analysis revealed that the factors associated with poor adherence were: 1) no history of previous admission due to asthma exacerbation; 2) the patient was male; and 3) the patient was young (<60 years). Conclusions: In the LTM group, re-evaluation of the actual severity of asthma and prompt treatment corresponding to the severity of disease should still be encouraged. In the non-LTM group, establishing countermeasures against factors causing poor adherence would be the next step in ensuring strong adherence with LTM.http://www.sciencedirect.com/science/article/pii/S1323893015307000adherenceasthmaexacerbationlong-term managementnear fatal asthma |
| spellingShingle | Kenji Baba Tsutomu Hattori Takeo Yagi Kazuyuki Onoe Seiko Kawai Kazuhito Yoshida Etsuro Yamaguchi Adherence with Long-Term Asthma Management in Patients Who Experienced Hospitalized Asthma Exacerbation Allergology International adherence asthma exacerbation long-term management near fatal asthma |
| title | Adherence with Long-Term Asthma Management in Patients Who Experienced Hospitalized Asthma Exacerbation |
| title_full | Adherence with Long-Term Asthma Management in Patients Who Experienced Hospitalized Asthma Exacerbation |
| title_fullStr | Adherence with Long-Term Asthma Management in Patients Who Experienced Hospitalized Asthma Exacerbation |
| title_full_unstemmed | Adherence with Long-Term Asthma Management in Patients Who Experienced Hospitalized Asthma Exacerbation |
| title_short | Adherence with Long-Term Asthma Management in Patients Who Experienced Hospitalized Asthma Exacerbation |
| title_sort | adherence with long term asthma management in patients who experienced hospitalized asthma exacerbation |
| topic | adherence asthma exacerbation long-term management near fatal asthma |
| url | http://www.sciencedirect.com/science/article/pii/S1323893015307000 |
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