Prescriptive adherence to GINA guidelines and asthma control: An Italian cross sectional study in general practice

Autor: Sandra Baldacci, Marzia Simoni, Sara Maio, Anna Angino, Franca Martini, Giuseppe Sarno, Sonia Cerrai, Patrizia Silvi, Anna Paola Pala, Megon Bresciani, Pierluigi Paggiaro, Giovanni Viegi, Francesco Di Pede, Bona Barbara Piegaia, Maurizio Mangione, Elena Bacci, Laura Carrozzi, Federico Dente, Francesco Pistelli, Lorenza Bancalari, Maria Pia Foschino, Andrea Pelucchi, Gianna Moscato, Pasquale Pierimarchi, Barbara Brunetto, Patrizia Iacovacci, Carlo Pini, Raffaella Tinghino, Francesco Forastiere, Carlo Alberto Perucci, Daniela Porta, Laura Ancona, Sara Protasi, Barbara Lazazzera, Valentina Ziroli, Eleonora D'Armini, Sabella Festa Campanile, Monica Ferri, Paola Lorusso, Riccardo Pistelli, Rita Salotti, Marco Santagati, Elisabetta Agea, Chiara Casciari, Nicola Murgia, Fabrizio Spinozzi, Floriano Bonifazi, Leonardo Antonicelli, Maria Chiara Braschi, Valeria Conti, Amelia Filippelli, Grazia Maria Corbi, Giusy Russomanno, Fulvio Braido, Walter Canonica, Francesco Balbi, Isa Cerveri, Angelo Corsico, Amelia Grosso
Přispěvatelé: Baldacci, S, Simoni, M, Maio, S, Angino, A, Martini, F, Sarno, G, Cerrai, S, Silvi, P, Pala, Ap, Bresciani, M, Paggiaro, P, Viegi, G, Corbi, G, as ARGA Collaborative, Group.
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Adult
Male
Pulmonary and Respiratory Medicine
medicine.medical_specialty
Chronic bronchitis
Cross-sectional study
Cross sectional study
GINA guidelines
General Practice
Drug prescription
Severity of Illness Index
Drug prescriptions
Allergic rhinitis
NO
03 medical and health sciences
Adherence
Allergic rhinitis
Asthma
Control
Cross sectional study
Drug prescriptions
GINA guidelines
0302 clinical medicine
Adrenal Cortex Hormones
Internal medicine
Administration
Inhalation
Severity of illness
Control
medicine
Allergic rhiniti
Humans
Anti-Asthmatic Agents
030212 general & internal medicine
Medical prescription
Adrenergic beta-2 Receptor Agonists
Asthma
business.industry
Chronic sinusitis
Middle Aged
medicine.disease
Rhinitis
Allergic
Comorbidity
Gina guidelines
Cross-Sectional Studies
Italy
030228 respiratory system
Adherence
Drug Therapy
Combination
Female
Guideline Adherence
business
Zdroj: Respiratory medicine 146 (2019): 10–17. doi:10.1016/j.rmed.2018.11.001
info:cnr-pdr/source/autori:Baldacci S; Simoni M; Maio S; Angino A; Martini F; Sarno G; Cerrai S; Silvi P; Pala AP; Bresciani M; Paggiaro P; Viegi G; and the ARGA Collaborative Group/titolo:Prescriptive adherence to GINA guidelines and asthma control: An Italian cross sectional study in general practice/doi:10.1016%2Fj.rmed.2018.11.001/rivista:Respiratory medicine/anno:2019/pagina_da:10/pagina_a:17/intervallo_pagine:10–17/volume:146
Popis: Background Although general practitioners (GPs) are frequently the first healthcare professionals whom asthma patients refer to for their symptoms, few studies have explored the extent of adherence to guidelines for asthma management based on data provided directly by GPs. Aims of the present study were to assess drug prescriptions for asthma by GPs and to evaluate prescriptive adherence to GINA guidelines (GL) and its relationship with disease control in real life. Methods 995 asthmatic patients (45% males, mean age 43.3 ± 17.7 yrs) were enrolled by 107 Italian GPs distributed throughout the country. Data on diagnosis, disease severity, prescribed anti-asthmatic drugs and control were collected through questionnaires filled out by GPs taking into consideration the 2009 GINA Guidelines. Data on drug use and chronic sinusitis, nasal polyposis, chronic bronchitis, emphysema were reported by patients through a self-administered questionnaire. Results The large majority of patients were classified by GPs as having intermittent (48.4%) or mild persistent asthma (25.3%); 61% had co-morbid allergic rhinitis (AR). The prevalent therapeutic regimen used by patients was a combination of inhaled corticosteroids (ICS) plus long-acting β2-agonists (LABA) (54.1%), even in the intermittent/mild persistent group. ICS as mono-therapy or in combination with other drugs but LABA, was the second most frequently adopted treatment (14.4%). In general, the GPs adherence to GL treatment indications was 28.8%, with a significant association with a good asthma control (OR 1.85, 95% CI 1.18–2.92). On the other hand, comorbidity (OR 0.52, 95% CI 0.32–0.84), moderate (0.44, 0.28–0.69) and severe (0.06, 0.02–0.20) persistent asthma showed significant negative effects on asthma control. Conclusions Our results show that over-treatment of intermittent/mild persistent asthma is frequent in the GPs setting while therapeutic regimens are more appropriately applied for moderate/severe asthma. In general, we found low adherence to GINA GL treatment recommendations even if its relevance in asthma control was confirmed.
Databáze: OpenAIRE
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