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- Hasselgren, Mikael, et al.
(författare)
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Management, asthma control and quality of life in Swedish adolescents with asthma
- 2005
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Ingår i: Acta Paediatrica. - : Taylor & Francis. - 0803-5253 .- 1651-2227. ; 94:6, s. 682-688
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Tidskriftsartikel (refereegranskat)abstract
- Aim: In Sweden, paediatricians or general practitioners treat most adolescents with asthma. This study compares management, treatment goals and quality of life for adolescents aged 15-18 y in paediatric or primary care. Material and methods: A random sample of patients answered a disease-specific and a quality-of-life (MiniAQLQ) questionnaire. Results: The 146 adolescents in paediatric care had more years with asthma, better continuity of annual surveillance, higher use of inhaled steroids and a stated better knowledge of their asthma than the 174 patients in primary care. No difference could be detected in asthma control or quality of life. Of all 320 adolescents, approximately 20% had woken at night due to asthma symptoms during the last week. About 15% had made unscheduled, urgent care visits and a third had used short-acting beta-agonist relievers more than twice a week. Quality-of-life scores were high and similar in both settings. Conclusions: Swedish adolescents with asthma are managed and treated somewhat differently in paediatric and primary care but with equal and, for the most part, satisfying results. The difference between the two settings probably reflects both differences in severity of asthma and different treatment traditions. For all adolescents, better fulfilment of goals regarding symptoms and exacerbations would be desirable, whereas a good quality of life including normal physical activity seems to have been achieved.
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| 5. |
- Lisspers, Karin, et al.
(författare)
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Organisation of asthma and COPD care in primary health care in Mid-Sweden
- 2006
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Ingår i: Primary Care Respiratory Journal. - : Springer Science and Business Media LLC. - 1471-4418 .- 1475-1534.
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Konferensbidrag (refereegranskat)abstract
- Objective: To investigate the organisation of primary health care with regard to management of asthma and COPD and relate it to the guidelines and quality indicators for organisation stated by the Swedish National Board of Health and Welfare and to an earlier study in the area. Background: The Swedish National Board of Health and Welfare assessed quality indicators for the organisation and equipment for asthma and COPD in primary health care in 2004. These are spirometer, pulse oximeter for assessing respiratory impairment, nebuliser for emergency treatment and an asthma/COPD clinic for patient education. Method: A postal survey in 2005 to 56 randomly selected primary health care centres in Mid-Sweden. The survey included questions about access to an asthma/COPD clinic, spirometer, pulse oximeter, nebuliser, organisation for smoking cessation and rehabilitation. Results: All centres answered the survey. 93% had a spirometer, 83% pulse oximeter, 90% nebuliser and 64% asthma/COPD clinic. 65% had access to a program for smoking cessation within primary care. Regarding resources for COPD patients 63% centres had access to physiotherapy, 71% to occupational therapy, 41% to a dietician and 93% to a social welfare official or psychologist. Conclusion: The possibilities to offer patients with asthma and COPD sufficient care is good regarding access to diagnostic tools as spirometers and pulse oximeters and nebulisers, while access to education through an asthma/COPD clinic is insufficient. Compared to the results from the AIM-study in 2000 primary health care centres with asthma clinics have increased from 52% to 64% and access to spirometer from 76% to 93%. Only two-thirds of the centres can offer a program for smoking cessation which is insufficient. The study shows that many centres have the resources to start pulmonary rehabilitation for patients with COPD.
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| 6. |
- Lisspers, Karin, et al.
(författare)
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Organisation of asthma care in primary health care in Mid-Sweden
- 2005
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Ingår i: Primary Care Respiratory Journal. - : Springer Science and Business Media LLC. - 1471-4418 .- 1475-1534. ; 14:3, s. 147-153
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To investigate the organisation of asthma care in 240 primary health care centres (PHCCs) in Mid-Sweden. METHODS: A cross-sectional study. Main outcomes were occurrence and structure of nurse-based asthma clinics according to nationally recommended criteria, and access and use of spirometers. RESULTS: 238 PHCCs (99%) responded. 16% reported a complete, and 37% an incomplete, asthma clinic. 47% of PHCCs had no asthma clinic. The incomplete asthma clinics usually lacked sufficient asthma nurse time, a scheduled nurse surgery and a responsible GP. 77% of the PHCCs had access to a spirometer and on average 19 spirometries/1000 inhabitants/year were performed. There was a large variation in the use of spirometers. CONCLUSION: Half of the PHCCs had an asthma clinic and a majority had access to a spirometer. More frequent use of spirometry and increased time provision for the asthma nurse would be likely to produce a substantial improvement in the standard of asthma care in primary health care.
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| 7. |
- Lisspers, Karin, et al.
(författare)
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Quality of life and measures of asthma control in primary health care
- 2007
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Ingår i: Journal of Asthma. - : Informa UK Limited. - 0277-0903 .- 1532-4303. ; 44:9, s. 747-751
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To study quality of life and asthma control in primary care. A total of 1,477 patients 15 to 45 years of age received questionnaires regarding asthma control (77% responded) and quality of life, Mini Asthma Quality of Life Questionnaire (MiniAQLQ), (74% responded). Patients using short-acting beta-agonists more than twice in the last week had clinically significant lower MiniAQLQ scores (5.17 versus 5.91). This finding was consistent for night awakenings during the previous week (4.42 versus 5.86), courses of oral corticosteroids (4.82 versus 5.69), and reported emergency consultations during the last 6 months (4.85 versus 5.71). Good asthma control is associated with better quality of life in asthma patients in primary care.
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- Ställberg, Björn, et al.
(författare)
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Asthma control in primary care in Sweden : a comparison between 2001 and 2005
- 2009
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Ingår i: Primary Care Respiratory Journal. - : Springer Science and Business Media LLC. - 1471-4418 .- 1475-1534. ; 18:4, s. 279-286
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To compare the degree of asthma control in 2001 and 2005 in a primary care setting in Sweden. METHOD: Two similar questionnaire surveys were performed in 2001 and 2005 with 1,012 and 224 asthma patients aged 18-45 randomly selected from 42 and 56 primary health care centres, respectively. A classification of asthma control similar to the GINA guidelines was made using information obtained from the questionnaire. RESULTS: In 2001, 36.6% had achieved asthma control, 23.8% were partly controlled and 39.6% uncontrolled. In 2005, the corresponding figures were 40.2%, 26.8% and 33.0%, respectively, with no difference between the two surveys (p=0.114). Uncontrolled asthma was more common in women (p<0.001 in the first and p<0.05 in the second survey) and smokers (p<0.01 in the first and p<0.01 in the second survey). The use of combination corticosteroid/long-acting bronchodilator inhalers had increased - 34.2% and 48.2%, respectively (p<0.001) - and many patients used their inhaled corticosteroids periodically. CONCLUSION: In spite of treatment guidelines many patients in Swedish primary care still have insufficient asthma control.
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- Ställberg, Björn, et al.
(författare)
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Factors related to the level of severity of asthma in primary care
- 2007
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Ingår i: Respiratory Medicine. - : Elsevier BV. - 0954-6111 .- 1532-3064. ; 101:10, s. 2076-2083
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The severity of asthma varies in patients in primary care. The aim of this study was to identify factors related to asthma severity in a primary care setting. METHODS: In this cross-sectional asthma study a random sample of 1477 patients, aged 15-45 years, from 42 primary health care centres received two questionnaires: one disease oriented and one quality of life oriented, MiniAQLQ. A classification of the asthma severity similar to the GINA guidelines was made with the information obtained from the questionnaire. The classification was based on current treatment, use of rescue medication, night symptoms, emergency consultations and use of oral steroids for treatment of exacerbations. RESULTS: Thirty-five per cent of the women and 24% of the men were classified as having severe asthma. Women used more inhaled corticosteroids, more often took long acting beta-2 agonists or a leukotrien antagonist in addition to corticosteroids, experienced more frequent night awakenings and were more often smokers than men. In a multivariable analysis, female sex increased the odds of having severe asthma by 60% as compared with male sex, age by 3% per year, not having the asthma prescription filled owing to cost by 59%, daily smoking by 66% and pollen allergy by 85%. CONCLUSIONS: Female sex, age, pollen and pet allergy, not having the asthma prescription filled owing to cost, and daily smoking were all independently associated with asthma severity.
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