Identification of clusters of asthma control: A preliminary analysis of the Inspirers studies

Autor: Filipa Todo Bom, José Torres da Costa, Ana Magnólia Mendes, Ricardo Gomes, Rute Almeida, Cláudia Pinto, João Lúcio de Azevedo, Medida – Medicina, Educação, Investigação, Desenvolvimento e Avaliação, Porto, Cláudia Chaves Loureiro, Maria Joana Catarata, Ana M. V. M. Pereira, Mariana Pereira, Maria João Vasconcelos, Centro Hospitalar e Universitário de Coimbra erviço de Imunoalergologia, Mariana Couto, Georgeta Oliveira, Ivete Afonso, João Cardoso, Rita Amaral, José Augusto Ferreira, Nuno Neuparth, Diana Bordalo, Fernanda Carvalho, Margarida Valério, J Marques, Joana Dias, Imunoalergologia, Grupo Hpa Saúde, Portimão, Bárbara Ramos, Anabela Lopes, Maria Fernanda Teixeira, Rita Gerardo, Marta Alves, M. M. Magalhães, Pedro Morais Silva, Cristina Jácome, Ana Palhinha, Sara Cabral, Maria Alvarenga Santos, Marta Santalha, Carmelita Ribeiro, Rodrigo Rodrigues Alves, Imunoalergologia, Centro de Imunoalergologia do Algarve, Portimão, Armandina Moreira da Silva Neto, José Ferraz de Oliveira, Inês Lopes, David Trincão, Ana S. P. Moreira, Cristina Lopes, Ana Patrícia Marques, Ana Arrobas, João Pereira, Alberto Costa, Serviço de Imunoalergologia, Centro Hospitalar de São João, Porto, Ana Castro Neves, Serviço de Imunoalergologia, Centro Hospitalar Universitário do Algarve, Portimão, Fernando Menezes, Ana Paula Aguiar, Raquel Câmara, Madalena Emiliano, Natacha Santos, Joana Carvalho, Didina Coelho, Luís Barata, João Fonseca, Joana Branco, Diana Pinto, Rosário Ferreira, Luis Araujo, José Carlos Cidrais Rodrigues, Espinho, Centro Hospitalar e Universitário de Coimbra Serviço de Imunoalergologia, Ana Todo Bom, M Correia, José de Mello Saúde Imunoalergologia, Diana Silva, Teresa Almeida, Carlos Angelo Nunes, Carlos Alves, Lilia Maia Santos, Lisboa Faculdade de Ciências Médicas, Marta Pereira, Centro Hospitalar de Leiria Imunoalergologia, Maria José Cálix, Adelaide Alves, Carlos Lozoya, Pedro Martins, Centro Hospitalar e Universitário de Coimbra Serviço de Pneumologia, Ricardo M. Fernandes, Paula Leiria Pinto
Přispěvatelé: Comprehensive Health Research Centre (CHRC) - pólo NMS, NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM), Centro de Estudos de Doenças Crónicas (CEDOC)
Rok vydání: 2020
Předmět:
Zdroj: Repositório Científico de Acesso Aberto de Portugal
Repositório Científico de Acesso Aberto de Portugal (RCAAP)
instacron:RCAAP
ISSN: 2184-3856
0871-9721
Popis: This work was funded by ERDF (European Regional Development Fund) through the operations: POCI- -01-0145-FEDER-029130 (“mINSPIRERS—mHealth to measure and improve adherence to medication in chronic obstructive respiratory diseases - generalisation and evaluation of gamification, peer support and advanced image processing technologies”) co-funded by the COMPETE2020 (Programa Operacional Competitividade e Internacionalização), Portugal 2020 and by Portuguese Funds through FCT (Fundação para a Ciência e a Tecnologia). © 2020, Sociedade Portuguesa de Alergologia e Imunologia Clinica. All rights reserved. Aims: To identify distinct asthma control clusters based on Control of Allergic Rhinitis and Asthma Test (CARAT) and to compare patients’ characteristics among these clusters. Methods: Adults and adolescents (≥13 years) with persistent asthma were recruited at 29 Portuguese hospital outpatient clinics, in the context of two observational studies of the INSPIRERS project. Demographic and clinical characteristics, adherence to inhaled medication, beliefs about inhaled medication, anxiety and depression, quality of life, and asthma control (CARAT, >24 good control) were collected. Hierarchical cluster analysis was performed using CARAT total score (CARAT-T). Results: 410 patients (68% adults), with a median (percentile 25–percentile 75) age of 28 (16-46) years, were analysed. Three clusters were identified [mean CARAT-T (min-max)]: cluster 1 [27(24-30)], cluster 2 [19(14-23)] and cluster 3 [10(2-13)]. Patients in cluster 1 (34%) were characterised by better asthma control, better quality of life, higher inhaler adherence and use of a single inhaler. Patients in clusters 2 (50%) and 3 (16%) had uncontrolled asthma, lower inhaler adherence, more symptoms of anxiety and depression and more than half had at least one exacerbation in the previous year. Further-more, patients in cluster 3 were predominantly female, had more unscheduled medical visits and more anxiety symp-toms, perceived a higher necessity of their prescribed inhalers but also higher levels of concern about taking these inhalers. There were no differences in age, body mass index, lung function, smoking status, hospital admissions or specialist physician follow-up time among the three clusters. Conclusion: An unsupervised method based on CARAT--T, identified 3 clusters of patients with distinct, clinically meaningful characteristics. The cluster with better asthma control had a cut-off similar to the established in the validation study of CARAT and an additional cut-off seems to distinguish more severe disease. Further research is necessary to validate the asthma control clusters identified. publishersversion published
Databáze: OpenAIRE
Externí odkaz: