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Update on asthma control in five European countries: results of a 2008 survey

P. Demoly, B. Gueron, K. Annunziata, L. Adamek, R. D. Walters
European Respiratory Review 2010 19: 150-157; DOI: 10.1183/09059180.00002110
P. Demoly
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B. Gueron
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K. Annunziata
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L. Adamek
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R. D. Walters
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  • FIGURE 1.
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    FIGURE 1.

    Asthma control index. An asthma control index was computed by country as the ratio of at least well-controlled to not well-controlled treated asthma sufferers. An index of >1 equates to a greater proportion of at least well-controlled and an index of <1 equates to a greater proportion of not well-controlled.

  • FIGURE 2.
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    FIGURE 2.

    Work productivity and activity impairment by control status. Work productivity impairment considers both absent (time missed from work) and present (impairment while working) results. ░: not well-controlled asthma; ▒: at least well-controlled asthma. Statistical comparisons were computed using the Chi-squared test. ***: p<0.001.

  • FIGURE 3.
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    FIGURE 3.

    Short-form (SF)-12 mean scores by control status. PCS: physical component score; MCS: mental component score. ░: not well-controlled asthma; ▒: at least well-controlled asthma. Statistical comparisons were computed using the unpaired t-test. ***: p<0.001.

Tables

  • Figures
  • Table. 1—

    Prevalence of asthma control for diagnosed and treated asthma in 2008

    All countriesFranceGermanyItalySpainUK
    Diagnosed asthma#15.15¶ (6)2.86 (6)3.71 (5)2.13¶ (4)1.61 (5)4.84 (10)
        Not well-controlled7.89 (52)1.17 (41)2.30 (62)1.35 (63)0.75 (47)2.33 (48)
        At least well-controlled7.25 (48)1.70 (59)1.41 (38)0.77 (36)0.86 (53)2.51 (52)
    Treated asthma#11.87 (78)1.98 (69)2.97 (80)1.47 (69)1.11 (69)4.32 (89)
        Not well-controlled6.72 (57)1.00 (51)2.00 (67)0.98 (67)0.53 (47)2.21 (51)
        At least well-controlled5.15 (43)0.98 (49)0.97 (33)0.49 (33)0.59 (53)2.11 (49)
    • Data are presented as prevalence millions (% total population) and prevalence millions (% of diagnosed asthma) for diagnosed asthma and treated asthma, respectively. #: extrapolated to EU population in millions; ¶: sum of not well-controlled and at least well-controlled greater than total due to rounding.

  • Table. 2—

    Proportion of patients with individual components of the Asthma Control Test™

    Diagnosed asthmap-value
    Not well-controlled#At least well-controlled¶
    Impact of asthma on work, school and home activities in past 4 weeks<0.001
        All of the time3.40.1
        Most of the time10.10.0
        Some of the time27.31.4
        A little of the time33.718.7
        None of the time25.479.8
    Frequency of shortness of breath in past 4 weeks<0.001
        At least once a day48.11.7
        3–6 times per week24.43.7
        Once or twice per week25.647.5
        None1.947.1
    Night-time awakenings due to asthma in past 4 weeks<0.001
        ≥4 nights per week17.00
        2–3 nights per week26.41.3
        Once a week16.93.3
        Once or twice per week39.895.4
    Frequency of rescue medication use<0.001
        ≥3 times per day14.80.6
        Once or twice per day38.07.1
        2–3 times per week24.68.2
        None or once a week22.684.1
    Self-rated asthma control in past 4 weeks<0.001
        Not at all controlled11.64.0
        Poorly controlled10.71.0
        Somewhat controlled35.04.7
        Well-controlled37.336.6
        Completely controlled5.353.6
    • Data are presented as % of patients, unless otherwise stated. #: n = 1,827; ¶: n = 1,792. Statistical comparisons were computed using the Chi-squared test.

  • Table. 3—

    Demographics and health characteristics of subjects with asthma by control status

    Diagnosed asthmap-value
    Not well-controlledAt least well-controlled
    Subjects n18271792
    Female62.553.3<0.001
    Age yrs47.31±15.642.85±15.7<0.001
    Age range yrs
        18–3426.637.2
        35–5438.938.0
        >5534.624.8
    Employment status
        Employed49.863.4<0.001
        Unemployed50.236.6<0.001
            Retired22.816.5
            On disability6.32.7
    Overweight#33.635.6<0.001
    Obese¶30.423.3<0.001
    Current/ex-smoker70.358.7
    Experienced the following in past 12 months
        Depression3118<0.001
        Anxiety4028<0.001
        Sleep difficulties4235<0.001
    Number of times spoken with doctor in last 12 months3.15±3.71.48±1.9<0.001
    Asthma treatment
        Controller medication64.746.2<0.001
        Rescue medication55.148.4<0.001
    MMAS among those treated for a symptomatic condition
        0 (highly adherent)36.435.4ns
        122.124.5ns
        217.416.8ns
        313.916.1ns
        4 (highly nonadherent)10.17.30.016
    • Data are presented as % or mean±sd, unless otherwise stated. MMAS: Morisky Medication Adherence Scale; ns: nonsignificant. #: body mass index ≥25 kg·m−2 and <30 kg·m−2; ¶: body mass index ≥30 kg·m−2. Statistical comparisons were computed using the Chi-squared test for percentages and unpaired t-tests for means.

  • Table. 4—

    Healthcare attitudes of respondents with asthma by control status

    Agree/strongly agree with statementDiagnosed asthmap-value
    Not well-controlled#At least well-controlled¶
    Unless there is a good reason to change my medication, I think it is best to continue taking my medication as I currently do72.068.00.032
    I prefer brand name medications to generic ones21.114.8<0.001
    Whenever I don't feel well, I should consult a medically trained professional41.745.80.04
    If I get sick, it is my own behaviour which determines how soon I get well again47.553.70.002
    My doctor knows about all the over-the-counter products that I use48.042.70.009
    I am afraid of needles27.021.2<0.001
    All prescription medications have side-effects43.334.8<0.001
    I would prefer if my medications were combined into fewer pills44.537.8<0.001
    I try to take a multivitamin each day to improve or maintain my health27.021.3<0.001
    Having regular contact with my physician is the best way for me to avoid illness29.919.9<0.001
    I try to take my medication at the same time every day65.259.70.005
    • Data are presented as %, unless otherwise stated. #: n = 1,827; ¶: n = 1,792. Statistical comparisons were computed using the Chi-squared test.

  • Table. 5—

    Health resource use in previous 6 months

    Healthcare resource useDiagnosed asthmap-value
    Not well-controlledAt least well-controlled
    Subjects n18271792
    Visited traditional medical provider94.689.6<0.001
    Traditional medical provider visits9.92±10.86.78±6.78<0.001
    Visited general/family practitioner80.875.80.0038
    Visited internist9.65.2<0.001
    Visited allergist15.69.6<0.001
    Visited pulmonologist11.45.7<0.001
    Visited ER24.515.9<0.001
    ER visits0.6±2.40.2±0.7<0.001
    Hospitalised17.49.9<0.001
    Times hospitalised0.4±2.80.2±0.6<0.001
    • Data are presented as % or mean±sd, unless otherwise stated. ER: emergency room. Statistical comparisons were computed using the Chi-squared test for percentages and unpaired t-tests for means.

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Update on asthma control in five European countries: results of a 2008 survey
P. Demoly, B. Gueron, K. Annunziata, L. Adamek, R. D. Walters
European Respiratory Review Jun 2010, 19 (116) 150-157; DOI: 10.1183/09059180.00002110

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Update on asthma control in five European countries: results of a 2008 survey
P. Demoly, B. Gueron, K. Annunziata, L. Adamek, R. D. Walters
European Respiratory Review Jun 2010, 19 (116) 150-157; DOI: 10.1183/09059180.00002110
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