Abstract
Background: Primary care physicians in Japan see many patients in a given day; consequently, they find it challenging to devote sufficient time for detailed clinical consultation and evaluation of asthma control status. The aim of this study was to investigate asthma symptoms that reveal the presence of inadequately controlled asthma. Methods: A pooled analysis of baseline data from 100 patients with asthma treated with inhaled corticosteroid(s) (ICS) alone or ICS/long-acting beta-agonist who participated in three previous clinical trials was performed. Asthma control status and asthmatic symptoms were determined using a five-item Asthma Control Questionnaire, and whether asthmatic symptoms reflect clinical markers was investigated. Results: Nocturnal awakening owing to asthmatic symptoms was observed only in the uncontrolled asthma group. Patient-reported wheezing was not observed in the group with well-controlled asthma, but was observed in all patients in the uncontrolled asthma group. Virtually all patients, irrespective of asthma control status, reported symptoms in the morning, limitation of normal daily activities, and shortness of breath. Conclusions: The presence of nocturnal awakening due to asthma and wheezing likely reflected uncontrolled asthma. These results will lead to re-recognition that clinical interview, querying nocturnal awakening from asthma and wheezing is a simple and useful approach to assess asthma control status in a primary care setting.
Highlights
The Japanese Guidelines for Adult Asthma (JGL) and the Global Initiative for Asthma (GINA) guidelines recommend appropriate treatment based on an accurate assessment of asthma severity and control status, which are reflected by symptoms and respiratory function, to achieve current control and reduce future risk [1] [2]
On comparing patient background data, significant differences were observed in body mass index (BMI), ACQ5 score, and Fres between the groups
Further study in real-world clinical settings is preferable. This exploratory study indicated that, in asthma treatment in a primary care setting, a patient’s asthma control status can be extrapolated from confirming nocturnal awakening from asthma and self-reported wheezing. Confirming these symptoms may be an easy and useful approach to assess asthma control status by primary care physicians who have some difficulties in assessing several parameters, including airway inflammation and small-airway dysfunction, in routine practice
Summary
The Japanese Guidelines for Adult Asthma (JGL) and the Global Initiative for Asthma (GINA) guidelines recommend appropriate treatment based on an accurate assessment of asthma severity and control status, which are reflected by symptoms and respiratory function, to achieve current control and reduce future risk [1] [2]. Several tests, including assessment of lung function(s), small-airway dysfunction and airway inflammation, are recommended for determining asthma control status [1] [2] Specific tests, such as spirometry, are insufficiently used in clinical practice to assess asthma control [5]. Primary care physicians in Japan see many patients in a given day; they find it challenging to devote sufficient time for detailed clinical consultation and evaluation of asthma control status. Conclusions: The presence of nocturnal awakening due to asthma and wheezing likely reflected uncontrolled asthma These results will lead to re-recognition that clinical interview, querying nocturnal awakening from asthma and wheezing is a simple and useful approach to assess asthma control status in a primary care setting
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