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1. Asthma management in a specialist setting: Results of an Italian Respiratory Society survey

Author

Braido, Fulvio, Baiardini, Ilaria, Alleri, Pietro, Bacci, Elena, Barbetta, Carlo, Bellocchia, Michela, Benfante, Alida, Blasi, Francesco, Bucca, Caterina, Busceti, Maria Teresa, Centanni, Stefano, Colanardi, Maria Cristina, Contoli, Marco, Corsico, Angelo, D'Amato, Maria, Di Marco, Fabiano, Marco, Dottorini, Ferrari, Marta, Florio, Giovanni, Fois, Alessandro Giuseppe, Foschino Barbaro, Maria Pia, Silvia, Garuti, Girbino, Giuseppe, Grosso, Amelia, Latorre, Manuela, Maniscalco, Sara, Mazza, Francesco, Mereu, Carlo, Molinengo, Giorgia, Ora, Josuel, Paggiaro, Pierluigi, Patella, Vincenzo, Pelaia, Girolamo, Pirina, Pietro, Proietto, Alfio, Rogliani, Paola, Santus, Pierachille, Scichilone, Nicola, Simioli, Francesca, Solidoro, Paolo, Terraneo, Silvia, Zuccon, Umberto, and Canonica, Giorgio Walter

Published
2017
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2. Asthma management in a specialist setting: Results of an Italian Respiratory Society survey

Author

Giorgio Walter Canonica, Fulvio Braido, Angelo Corsico, Elena Bacci, Paola Rogliani, Giuseppe Girbino, Pierluigi Paggiaro, Fabiano Di Marco, Pierachille Santus, Michela Bellocchia, Maria D'Amato, Amelia Grosso, Ilaria Baiardini, Pietro Pirina, Manuela Latorre, Alfio Proietto, Stefano Centanni, Paolo Solidoro, Maria Teresa Busceti, Garuti Silvia, Maria Cristina Colanardi, Girolamo Pelaia, Umberto Zuccon, Nicola Scichilone, Giorgia Molinengo, Maria Pia Foschino Barbaro, Francesco Blasi, Silvia Terraneo, Josuel Ora, Caterina Bucca, Carlo Mereu, Pietro Alleri, Alida Benfante, Marta Ferrari, Carlo Barbetta, Alessandro G. Fois, Giovanni Florio, Sara Maniscalco, Marco Contoli, Francesco Mazza, Francesca Simioli, Dottorini Marco, Vincenzo Patella, Braido, Fulvio, Baiardini, Ilaria, Alleri, Pietro, Bacci, Elena, Barbetta, Carlo, Bellocchia, Michela, Benfante, Alida, Blasi, Francesco, Bucca, Caterina, Busceti, Maria Teresa, Centanni, Stefano, Colanardi, Maria Cristina, Contoli, Marco, Corsico, Angelo, D'Amato, Maria, Di Marco, Fabiano, Marco, Dottorini, Ferrari, Marta, Florio, Giovanni, Fois, Alessandro Giuseppe, Foschino Barbaro, Maria Pia, Silvia, Garuti, Girbino, Giuseppe, Grosso, Amelia, Latorre, Manuela, Maniscalco, Sara, Mazza, Francesco, Mereu, Carlo, Molinengo, Giorgia, Ora, Josuel, Paggiaro, Pierluigi, Patella, Vincenzo, Pelaia, Girolamo, Pirina, Pietro, Proietto, Alfio, Rogliani, Paola, Santus, Pierachille, Scichilone, Nicola, Simioli, Francesca, Solidoro, Paolo, Terraneo, Silvia, Zuccon, Umberto, and Canonica, Giorgio Walter

Subjects
Pulmonary and Respiratory Medicine, Adult, Male, medicine.medical_specialty, Concordance, Socio-culturale, Practice Patterns, Settore MED/10 - Malattie Dell'Apparato Respiratorio, Severity of Illness Index, 03 medical and health sciences, 0302 clinical medicine, Quality of life (healthcare), Retrospective Studie, Surveys and Questionnaires, Severity of illness, Health care, medicine, Surveys and Questionnaire, Humans, Pharmacology (medical), 030212 general & internal medicine, Practice Patterns, Physicians', Aged, Asthma, Female, Italy, Middle Aged, Retrospective Studies, Quality of Life, Specialization, Modalities, Physicians', business.industry, Biochemistry (medical), Retrospective cohort study, medicine.disease, 030228 respiratory system, Test score, Family medicine, Physical therapy, business, Human
Abstract

Background Asthma considerably impairs patients' quality of life and increases healthcare costs. Severity, morbidity, and degree of disease control are the major drivers of its clinical and economic impact. National scientific societies are required to monitor the application of international guidelines and to adopt strategies to improve disease control and better allocate resources. Aim to provide a detailed picture of the characteristics of asthma patients and modalities of asthma management by specialists in Italy and to develop recommendations for the daily management of asthma in a specialist setting. Method: A quantitative research program was implemented. Data were collected using an ad hoc questionnaire developed by a group of specialists selected by the Italian Pneumology Society/Italian Respiratory Society. Results The records of 557 patients were analyzed. In the next few years, specialists are expected to focus their activity patients with more severe disease and will be responsible for selection of patients for personalized biological therapy; however, only 20% of patients attending Italian specialist surgery can be considered severe. In 84.4% of cases, the visit was a follow-up visit requested in 82.2% of cases by the specialist him/herself. The Asthma Control Test is used only in 65% of patients. When available, a significant association has been observed between the test score and asthma control as judged by the physician, although concordance was only moderate (κ = 0.68). Asthma was considered uncontrolled by the specialist managing the case in 29.1% of patients; nevertheless, treatment was not stepped up in uncontrolled or partly controlled patients (modified in only 37.2% of patients). Conclusions The results of this survey support re-evaluation of asthma management by Italian specialists. More resources should be made available for the initial visit and for more severely ill patients. In addition, more extensive use should be made of validated tools, and available drugs should be used more appropriately.

Published
2017

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