The impact of dysfunctional breathing on the level of asthma control in difficult asthma
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The impact of dysfunctional breathing on the level of asthma control in difficult asthma. / Sedeh, Farnam Barati; Von Bülow, Anna; Backer, Vibeke; Bodtger, Uffe; Petersen, Ulrik Søes; Vest, Susanne; Hull, James H; Porsbjerg, Celeste.
I: Respiratory Medicine, Bind 163, 105894, 2020.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - The impact of dysfunctional breathing on the level of asthma control in difficult asthma
AU - Sedeh, Farnam Barati
AU - Von Bülow, Anna
AU - Backer, Vibeke
AU - Bodtger, Uffe
AU - Petersen, Ulrik Søes
AU - Vest, Susanne
AU - Hull, James H
AU - Porsbjerg, Celeste
N1 - Copyright © 2020 Elsevier Ltd. All rights reserved.
PY - 2020
Y1 - 2020
N2 - BACKGROUND: Difficult asthma is defined as asthma requiring high dose treatment. However, systematic assessment is required to differentiate severe asthma from difficult-to-treat asthma. Dysfunctional breathing (DB) is a common comorbidity in difficult asthma, which may contribute to symptoms, but how it affects commonly used measures of symptom control is unclear.METHODS: All adult asthma patients seen in four respiratory clinics over one year were screened prospectively, and patients with possible severe asthma according to ERS/ATS criteria ('Difficult asthma': high-dose inhaled corticosteroids/oral corticosteroids), underwent systematic assessment. Symptoms of DB were assessed utilizing a symptom based subjective tool, Nijmegen questionnaire (NQ), and objective signs of DB with the Breathing Pattern Assessment Tool (BPAT). Asthma control and quality of life were evaluated with the Asthma Control Questionnaire (ACQ) and the mini Asthma Quality of Life Questionnaire (AQLQ).RESULTS: A total of 117 patients were included. Among these, 29.9% (35/117) had DB according to the NQ. Patients with DB had a poorer asthma control (ACQ: Mean (SD) 2.86 ± 1.05 vs. 1.46 ± 0.93) and lower quality of life (AQLQ score: Mean (SD) 4.2 ± 1.04 vs. 5.49 ± 0.85) compared to patients without DB. Similarly, patients with objective signs of DB according to the BPAT score had worse asthma control: BPAT >4 vs < 4: (ACQ: Mean (SD) 3.15 ± 0.93 vs 2.03 ± 1.15).CONCLUSION: DB is common among patients with difficult asthma, and is associated with significantly poorer asthma control and lower quality of life. Assessment and treatment of DB is an important part of the management of difficult asthma.
AB - BACKGROUND: Difficult asthma is defined as asthma requiring high dose treatment. However, systematic assessment is required to differentiate severe asthma from difficult-to-treat asthma. Dysfunctional breathing (DB) is a common comorbidity in difficult asthma, which may contribute to symptoms, but how it affects commonly used measures of symptom control is unclear.METHODS: All adult asthma patients seen in four respiratory clinics over one year were screened prospectively, and patients with possible severe asthma according to ERS/ATS criteria ('Difficult asthma': high-dose inhaled corticosteroids/oral corticosteroids), underwent systematic assessment. Symptoms of DB were assessed utilizing a symptom based subjective tool, Nijmegen questionnaire (NQ), and objective signs of DB with the Breathing Pattern Assessment Tool (BPAT). Asthma control and quality of life were evaluated with the Asthma Control Questionnaire (ACQ) and the mini Asthma Quality of Life Questionnaire (AQLQ).RESULTS: A total of 117 patients were included. Among these, 29.9% (35/117) had DB according to the NQ. Patients with DB had a poorer asthma control (ACQ: Mean (SD) 2.86 ± 1.05 vs. 1.46 ± 0.93) and lower quality of life (AQLQ score: Mean (SD) 4.2 ± 1.04 vs. 5.49 ± 0.85) compared to patients without DB. Similarly, patients with objective signs of DB according to the BPAT score had worse asthma control: BPAT >4 vs < 4: (ACQ: Mean (SD) 3.15 ± 0.93 vs 2.03 ± 1.15).CONCLUSION: DB is common among patients with difficult asthma, and is associated with significantly poorer asthma control and lower quality of life. Assessment and treatment of DB is an important part of the management of difficult asthma.
KW - Administration, Inhalation
KW - Administration, Oral
KW - Adrenal Cortex Hormones/administration & dosage
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Asthma/diagnosis
KW - Cross-Sectional Studies
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Prospective Studies
KW - Quality of Life
KW - Respiration
KW - Severity of Illness Index
KW - Young Adult
U2 - 10.1016/j.rmed.2020.105894
DO - 10.1016/j.rmed.2020.105894
M3 - Journal article
C2 - 32056838
VL - 163
JO - Respiratory Medicine
JF - Respiratory Medicine
SN - 0954-6111
M1 - 105894
ER -
ID: 257029163