Change in the symptom profile treated as asthma \u2013 two cross-sectional studies twenty years apart

Mihkel Pindus,Rain Jõgi,Hans Orru

doi:10.1186/s12931-020-1308-3

Abstract

AimsThe aims of the study were to investigate prevalence trends of respiratory symptoms, asthma and asthma treatment among young adults in Estonia and to estimate changes in symptom profile among subjects who self-report asthma attacks or use asthma medications.MethodsTwo similar questionnaires on respiratory health were sent to subjects in Tartu, Estonia, aged between 20 and 44 years; first in 1993/94, and then in 2014/15. To study the impact of different respiratory symptoms on asthma diagnosis and treatment, the log–binomial regression was used to estimate the association between ‘attack of asthma’ (as a proxy for current asthma) and respiratory symptoms as well as asthma treatment and respiratory symptoms, adjusted for age, sex and smoking history.ResultsSelf–reported prevalence of asthma attack, asthma medication use and nasal allergies increased over the twenty years between studies, whereas there was no change in prevalence of asthma–related symptoms, and the prevalence of most respiratory symptoms either decreased, or remained unchanged. For women experiencing asthma attacks, the prevalence of nasal allergies increased and waking with chest tightness decreased. For men using asthma medication, the prevalence of a wheeze without a cold decreased. Women using asthma medication reported decreased prevalence of waking with chest tightness.ConclusionSelf-reported asthma attacks and asthma medication use has increased in last 20 years, while the prevalence of most respiratory symptoms either decreased or did not change. It is likely that changes in asthma symptom profile have had an impact on the prevalence of asthma and asthma treatment.

Highlights

During the second half of the twentieth Century, surveys repeated in the same location and using similar methods generally showed an increased prevalence of asthma and respiratory symptoms over time, both amongst children [1, 2] and adults [3, 4]
Some have demonstrated an increase in both the prevalence of self–reported asthma diagnosis and respiratory symptoms suggestive of asthma; whereas others have shown no change in asthma attacks
This aligns with results from previous similar studies, where increases in asthma attacks and medication use corresponded with a decrease in asthma–related respiratory symptoms [7,8,9,10,11]

Summary

Introduction

During the second half of the twentieth Century, surveys repeated in the same location and using similar methods generally showed an increased prevalence of asthma and respiratory symptoms over time, both amongst children [1, 2] and adults [3, 4]. Some have demonstrated an increase in both the prevalence of self–reported asthma diagnosis and respiratory symptoms suggestive of asthma; whereas others have shown no change in asthma attacks. Few studies have described the change in symptom profile over time for subjects with self–reported asthma, and no clear picture has emerged. The current study aimed, firstly, to investigate prevalence trends for respiratory symptoms, asthma diagnosis and asthma treatment among young adults in Tartu, Estonia. The study examined long–term changes in the symptom profile of subjects who either self–report asthma attacks or use asthma medications

Methods

Results

Discussion

Conclusion