Four seasons of Czech asthma study: asthma characteristics and management reality in the Czech Republic
Language English Country England, Great Britain Media print-electronic
Document type Journal Article, Multicenter Study, Observational Study, Research Support, Non-U.S. Gov't
- Keywords
- Epidemiological survey, allergologists, allergy, asthma diagnosis, eosinophilia; pulmonologists, medical overuse, phenotyping,
- MeSH
- Adrenergic beta-2 Receptor Agonists administration & dosage MeSH
- Allergy and Immunology standards statistics & numerical data trends MeSH
- Anti-Asthmatic Agents administration & dosage MeSH
- Administration, Inhalation MeSH
- Asthma diagnosis drug therapy MeSH
- Budesonide administration & dosage MeSH
- Guideline Adherence statistics & numerical data trends MeSH
- Adult MeSH
- Drug Combinations MeSH
- Formoterol Fumarate MeSH
- Glucocorticoids administration & dosage MeSH
- Drug Therapy, Combination methods statistics & numerical data MeSH
- Drug Prescriptions statistics & numerical data MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Delayed Diagnosis statistics & numerical data MeSH
- Pulmonary Medicine standards statistics & numerical data trends MeSH
- Cross-Sectional Studies MeSH
- Aged MeSH
- Practice Guidelines as Topic MeSH
- Societies, Medical standards MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Observational Study MeSH
- Research Support, Non-U.S. Gov't MeSH
- Geographicals
- Czech Republic MeSH
- Names of Substances
- Adrenergic beta-2 Receptor Agonists MeSH
- Anti-Asthmatic Agents MeSH
- Budesonide MeSH
- Drug Combinations MeSH
- Formoterol Fumarate MeSH
- Glucocorticoids MeSH
Objective: To describe the characteristics and management of asthma in clinical practice in the Czech Republic in the context of international guidelines and clinical realities.Methods: Data were collected over four seasons from summer 2016 to spring 2017 and are mostly presented using descriptive statistics.Results: We obtained valid data for 4557 adult patients with asthma, including detailed phenotyping (71% eosinophilic allergic, 10% eosinophilic non-allergic, 19% non-eosinophilic non-allergic asthma) from 58 allergologists and 56 pulmonologists. The average time to diagnosis was 3 years. In more than half of the subjects, bronchodilator testing (BDT) results were available at primary diagnosis. More than 10% of physicians did not test for mold allergy. Occupational asthma was diagnosed in 0.7% of subjects. According to the attending physician, 68% of patients had well-controlled and 10% had uncontrolled asthma. Ninety-four percent of patients were on preventive treatment, with 91% using an inhaled corticosteroids (ICS) at an average dose of 705 µg/day budesonide equivalent. Approximately 75% of patients were on an ICS/LABA, with 91% using fixed combinations. Among patients using ICS/formoterol, a maintenance and reliever therapy regime was prescribed in 67%.Conclusions: The quality of asthma management in the Czech Republic is comparable to that of other developed countries and better in some respects (frequent BDT, phenotyping, and use of preventive treatment). Nevertheless, there is unnecessary delay in diagnosis and lack of research on possible environmental causes (workplace, molds). Pharmacotherapy shows good adherence to guidelines. Although 10% of patients show poor control, there is concurrently a trend for overtreatment.
Data Analysis Department Institute of Biostatistics and Analysis Brno Czech Republic
Department of Allergology and Clinical Immunology University Hospital Olomouc Olomouc Czech Republic
References provided by Crossref.org
Subsets of Eosinophils in Asthma, a Challenge for Precise Treatment
