Abstract
ObjectivesThe study aimed at prospectively evaluating the evolution of asthma control in Italy, to evaluate the reasons for lack of asthma control, perceived quality of life (QoL) and association with level of asthma control, the impact of pharmacological treatment, the number of exacerbations and the healthcare resource consumption.MethodsPRISMA (PRospectIve Study on asthMA control) was an observational study performed in asthmatic patients including a cross-sectional phase and a 12-month prospective phase. Asthma control was assessed with the Asthma Control Test™ (ACT) and QoL was evaluated with EuroQoL-5D questionnaire filled in and collected during 5 clinic visits together with all the other data.ResultsThe prospective phase included 1017 patients with uncontrolled (55.7%) or partly controlled asthma (44.3%). Out of the 739 patients evaluable after 12 months, 22.2% achieved full asthma control (ACT score = 25) and 58.7% reached a good control (ACT score: 20–24). The improvement in asthma control was associated with improved QoL and reduced hospital visits. The main reasons for lack of asthma control were comorbidities, continued exposure to irritants/triggers and poor adherence to therapy. The frequency of exacerbations was lower in patients with controlled asthma.A fixed combination therapy with an inhaled corticosteroid and a long-acting β2 agonist was reported by 77.0% of patients. A better asthma control and improved QoL were achieved with extrafine beclomethasone/formoterol compared to either budesonide/formoterol or fluticasone/salmeterol.ConclusionsAn improvement in asthma control and QoL can be achieved during a 1-year monitoring in a real life setting. Extrafine beclomethasone/formoterol was associated with significant benefit in terms of asthma control and QoL compared to large-particles combinations.ClinicalTrials.gov number NCT01110460.
Highlights
According to international guidelines, once treatment has been established, therapeutic management of asthma should be based on asthma control, rather than asthma severity [1,2]
The PRISMA (PRospectIve Study on asthMA control) observational study was designed to include a crosssectional phase and a 12-month prospective phase in order to estimate the level of asthma control in real life and its evolution during a 1-year follow up
In the PRISMA study, patients filled in validated questionnaires for asthma control and quality of life (QoL) measurement and data were collected during visits by respiratory specialists
Summary
Once treatment has been established, therapeutic management of asthma should be based on asthma control, rather than asthma severity [1,2]. The results of the cross-sectional phase of the PRISMA study, investigating the level of asthma control in 2853 patients with asthma recruited in 56 respiratory clinics in Italy have been recently published [6]. Previous studies were available evaluating the control of asthma but comprised smaller populations and with a less representative distribution throughout the country [7,8,9,10,11]. In the PRISMA study, patients filled in validated questionnaires for asthma control and QoL measurement and data were collected during visits by respiratory specialists. Previous studies have collected data by telephone interviews [7,8,9], web-based questionnaires [11,12,13], or postal screening questionnaires [14]
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