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Biomedical subjects

B P A Thoonen

Publications and source records attributed to B P A Thoonen.

2 recordsLinked to original sources

Factors associated with asthma control.

The aim of this study was to evaluate which factors are associated with asthma control experienced by asthma patients. In a cross-sectional study patients aged 16-60 years with mild to moderate asthma were selected. The influence of the following factors on asthma control was studied in a multivariate model: age, gender, socioeconomic status, smoking, perceived hyperresponsiveness (PHR, responding with asthma symptoms to one or more triggers), allergy (Phadiatop), long-acting bronchodilating agents, and inhaled corticosteroids. Asthma control was measured by means of the Asthma Control Questionnaire (ACQ) as developed by Juniper. Forced expiratory volume in 1 second (FEV1) was measured by means of a portable spirometer. In this study with 311 patients, mean ACQ score was 1.39 (range 0-4.43). A stepwise backward linear regression analysis showed that low socioeconomic status (beta 0.425; p=0.001), current smoking (beta 0.555; p<0.001), high dose of inhaled corticosteroids (beta 0.364; p=0.04) and perceived hyperresponsiveness for increasing number of different triggers (PHR for 1 trigger beta 0.833; p=0.03; 2 triggers beta 0.810; p=0.03; 3 triggers beta 0.995; p=0.01; 4 triggers beta 1.131; p=0.002; 5 triggers beta 1.182; p=0.002) are independent predictors for poorer asthma control. Beside treatment with medication, stopping smoking and avoidance of triggers are factors, which may have a high impact on asthma control.

Administration, Inhalation↗

Self-management of asthma in general practice, asthma control and quality of life: a randomised controlled trial.

BACKGROUND: A study was undertaken to determine the effectiveness of asthma self-management in general practice. METHODS: Nineteen general practices were randomly allocated to usual care (UC) or self-management (SM). Asthma patients were included after confirmation of the GP diagnosis. Follow up was 2 years. Patients kept diary cards and visited the lung function laboratory every 6 months. Outcomes were number of successfully treated weeks, limited activity days, asthma specific quality of life, forced expiratory volume in 1 second (FEV(1)), FEV(1) reversibility, concentration of histamine provoking a fall in FEV(1) of 20% or more (PC(20) histamine), and amount of inhaled steroids. RESULTS: A total of 214 patients were included in the study (104 UC/110 SM; one third of the total asthma population in general practice); 62% were female. The mean percentage of successfully treated weeks per patient in the UC group was 72% (74/103 weeks) compared with 78% (81/105 weeks) in the SM group (p=0.003). The mean number of limited activity days was 1.2 (95% CI 0.5 to 1.9) in the SM group and 3.9 (95% CI 2.5 to 5.4) in the UC group. The estimated increase in asthma quality of life score was 0.10 points per visit in the UC group and 0.21 points per visit in the SM group (p=0.055). FEV(1), FEV(1) reversibility, and PC(20) histamine did not change. There was a saving of 217 puffs of inhaled steroid per patient in favour of the SM group (p<0.05). CONCLUSION: Self-management lowers the burden of illness as perceived by patients with asthma and is at least as effective as the treatment usually provided in Dutch primary care. Self-management is a safe basis for intermittent treatment with inhaled corticosteroids.

Adult↗