- 作者：Lucia Cazzoletti ; Aless ; ro Marcon ; Christer Janson ; Angelo Corsico ; Deborah Jarvis ; Isabelle Pin ; Simone Accordini ; Enrique Almar ; Massimiliano Bugiani ; Adriana Carolei ; Isa Cerveri ; Enric Duran-Tauleria ; David Gislason ; Amund Gulsvik ; Rain Jõ ; gi ; Aless ; ra Marinoni ; Jesú ; s Martí ; nez-Mora
- 关键词：Asthma control ; inhaled corticosteroids ; Global Initiative for Asthma ; predictors of uncontrolled asthma ; Cladosporium species ; total IgE ; body mass index ; European Community Respiratory Health Survey ; population-based study ; cross-sectional study
- 刊名：Journal of Allergy and Clinical Immunology
- 出版年：2007
- 出版时间：December 2007
- 年：2007
- 卷：120
- 期：6
- 页码：1360-1367
- 全文大小：328 K
Background
Epidemiologic evidence related to asthma control in patients from the general population is scanty.Objectives
We sought to assess asthma control in several European centers according to the Global Initiative for Asthma (GINA) guidelines and to investigate its determinants.
Methods
In the European Community Respiratory Health Survey II (1999-2002), 1241 adults with asthma were identified and classified into inhaled corticosteroid (ICS) users and non-ICS users in the last year. Control was assessed in both groups by using the GINA proposal (controlled, partly controlled, and uncontrolled asthma), and it was related to potential determinants.
Results
Only 15 % (95 % CI, 12 % to 19 % ) of subjects who had used ICSs in the last year and 45 % (95 % CI, 41 % to 50 % ) of non-ICS users had their asthma under control; individuals with uncontrolled asthma accounted for 49 % (95 % CI, 44 % to 53 % ) and 18 % (95 % CI, 15 % to 21 % ), respectively. Among ICS users, the prevalence of uncontrolled asthma showed great variability across Europe, ranging from 20 % (95 % CI, 7 % to 41 % ; Iceland) to 67 % (95 % CI, 35 % to 90 % ; Italy). Overweight status, chronic cough and phlegm, and sensitization to Cladosporium species were associated with poor control in ICS users. About 65 % and 87 % of ICS users with uncontrolled and partly controlled asthma, respectively, were on a medication regimen that was less than recommended by the GINA guidelines.
Conclusion
Six of 7 European asthmatic adults using ICSs in the last year did not achieve good disease control. The large majority of subjects with poorly controlled asthma were using antiasthma drugs in a suboptimal way. A wide variability in asthma control emerged across Europe.
Clinical implications
Greater attention should be paid to asthma management and to the implementation of the GINA guidelines.