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- Geale, Kirk, et al.
(författare)
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Late Breaking Abstract - NORdic Database for aSThmA Research (NORDSTAR) : Swedish and Finnish patients
- 2018
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Ingår i: European Respiratory Journal. - : European Respiratory Society. - 0903-1936 .- 1399-3003. ; 52
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background: A cross-border research collaboration was recently initiated across the Nordic countries. These countries maintain population-based registers containing a variety of patient-level health and socioeconomic variables, providing a basis for nation-wide, longitudinal research.Aims and objectives: Describe key characteristics of Swedish and Finnish asthma populations in 2014.Methods: NORDSTAR is a research platform with ethical approval based on Nordic register data. Patients with an asthma diagnosis (ICD-10: J45/46) at any age in specialist care, or ≥2 dispensed respiratory prescriptions (ATC: R03) while aged 6-44, during 2004-2014 were included. Those with diagnosis and treatment pairs unlikely to be asthma were excluded. Demographics (age, sex, income, education level, and urban residence), treatment, comorbidities, and asthma specialist visits in 2014 were described using summary statistics.Results: Finnish comorbidity levels appeared higher than in Sweden. More Finnish patients filled OCS prescriptions (24%) than Swedish patients (20%). Most Swedish patients lived in an urban setting, and the distribution of education level was similar to the general population. Mean family income was 49,960 and 42,840 EUR in Sweden and Finland respectively, while 31% and 44% of patients visited an asthma specialist. Prevalence of asthma was highest among women in both countries, and age distributions were similar.Conclusions: NORDSTAR is a platform for conducting asthma outcomes research in the Nordics. Swedish and Finnish patients appear to be similar in many dimensions except for prevalence of asthma specialist care contacts.
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- Miravitlles, Marc, et al.
(författare)
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A review of national guidelines for management of COPD in Europe
- 2016
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Ingår i: European Respiratory Journal. - : European Respiratory Society (ERS). - 0903-1936 .- 1399-3003. ; 47:2, s. 625-637
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Forskningsöversikt (refereegranskat)abstract
- The quality of care can be improved by the development and implementation of evidence-based treatment guidelines. Different national guidelines for chronic obstructive pulmonary disease (COPD) exist in Europe and relevant differences may exist among them. This was an evaluation of COPD treatment guidelines published in Europe and Russia in the past 7 years. Each guideline was reviewed in detail and information about the most important aspects of patient diagnosis, risk stratification and pharmacotherapy was extracted following a standardised process. Guidelines were available from the Czech Republic, England and Wales, Finland, France, Germany, Italy, Poland, Portugal, Russia, Spain and Sweden. The treatment goals, criteria for COPD diagnosis, consideration of comorbidities in treatment selection and support for use of long-acting bronchodilators, were similar across treatment guidelines. There were differences in measures used for stratification of disease severity, consideration of patient phenotypes, criteria for the use of inhaled corticosteroids and recommendations for other medications (e.g. theophylline and mucolytics) in addition to bronchodilators. There is generally good agreement on treatment goals, criteria for diagnosis of COPD and use of long-acting bronchodilators as the cornerstone of treatment among guidelines for COPD management in Europe and Russia. However, there are differences in the definitions of patient subgroups and other recommended treatments.
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- Pakkasela, Johanna, et al.
(författare)
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Age at asthma diagnosis in subjects with and without allergic rhinitis
- 2018
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Ingår i: European Respiratory Journal. - : European Respiratory Society. - 0903-1936 .- 1399-3003. ; 52
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background: Onset of allergic asthma has a strong association with childhood. Much less is known about adult onset asthma and its association with allergy.Objectives: To assess the proportion of allergic and non-allergic asthma in adulthood in relation to the age at asthma diagnosis.Methods: Postal questionnaires were sent to 8000 randomly selected recipients aged 20-69 years in Finland in 2016. The participation rate was 52% (n=4173). Asthma was classified allergic when a physician-diagnosed asthma and a physician-diagnosed allergic rhinitis were both reported.Results: The prevalence of physician-diagnosed asthma and allergic rhinitis were 11% (n=445) and 18%, respectively. Mean ages at diagnosis of allergic asthma and non-allergic asthma were 19 and 35 years, respectively. Among subjects with asthma diagnosis at ages 0-19, 20-39 and 50-69 years, 67%, 55% and 23%, respectively, were allergic. For non-allergic asthma, the incidence rate of asthma was lowest in children and young adults (0.7/1000/year). It increased after middle age and was highest in older age groups (2.4/1000/year in 50-59 years old).Conclusions: The study results support the well-recognized fact that childhood asthma is mostly allergic. To our knowledge, this is the first study to show that the proportion of allergic asthma steadily declines with advancing age at asthma diagnosis and non-allergic asthma becomes the dominant phenotype with asthma diagnosed in middle age.
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