Patients Do Not Believe Disease Is Chronic
If inner-city adults with asthma do not see their condition as chronic, researchers are worried that this perception will interfere with asthma management. A study, reported in Chest (March 2006), surveyed 198 adults who were hospitalized with asthma at an inner-city hospital over a 12-month period. The patients were asked to gauge their perceptions about their disease, medication use, and other health issues. The investigators noted that the participants were largely low-income and non-Caucasian individuals who had to go to the emergency room for asthma or be admitted to the hospital.
The study found that 53% of the patients believed that when they did not exhibit symptoms they did not have asthma. Men and older patients were most likely to have this "no symptoms, no asthma"perception. Also, these patients often expected to be cured. Patients who believed that the disease was not chronic were 33% less likely to follow inhaled steroid treatment when they were symptom-free.
Pharmacists Launch Asthma Program
The National Community Pharmacists Association, Medical Care and Outcomes LLC, and GlaxoSmithKline recently launched the Asthma Intervention Program. The nationwide pilot program will examine the vital role pharmacists can play in identifying patients with uncontrolled asthma and helping them by means of medication therapy management. The pilot will be limited to 500 pharmacies nationwide.
The program will use the Asthma Control Test, a 5-question assessment tool recommended by the American Lung Association, to evaluate how well a patient's asthma currently is being controlled. A series of interventions, as well as communications with the patient's physician for 6 months, will assess the impact pharmacists can have in delivering patient care services and improving health outcomes.
For the study, each participating pharmacy will be required to enroll at least 15 patients. Patient data will be entered electronically into a Health Insurance Portability and Accountability Act-compliant database developed by Medical Care and Outcomes, which is available on-line through Pharmacist e-Link. For more information, visit www.pharmacistelink.com/asthma.
Study Finds Leptin Correlation with Asthma
Evidence linking leptin levels with asthma in children prompted researchers to determine whether the result was true for adults. Data from 5876 participants in the Third National Health and Nutrition Examination Survey found that high levels of leptin correlated with physician-diagnosed asthma in adults.
The researchers found, however, that the association was stronger in women than in men and stronger in premenopausal women, compared with postmenopausal women.
As in earlier reports, body mass index was directly related to asthma risk. Taking leptin levels into account had very little effect on this association, according to the report in Thorax (April 2006).
The researchers are planning to investigate the roles of other fat-produced compounds in the development of asthma. A focus will be on adiponectin, an antiinflammatory protein that may offset the effects of leptin.
Asthma Still Is Poorly Controlled
Despite many treatment options for asthma, new findings suggest that patients have experienced emergency department visits, hospitalizations, or attacks at a rate that has not declined significantly over time.
For the study, the researchers reviewed 3998 case records in an administrative claims database of a managed care setting. The patients included had an asthma diagnosis and >2 claims per year for asthma medications over 4 years. The results of the study showed that over 4 years the exacerbation rate did not drop much.
The data indicated that 41% of patients had at least one asthma exacerbation. Of these patients, 30% were not taking daily asthma maintenance medication before the exacerbation. In addition, patients who had an exacerbation in the first year of the study were about 2 times as likely to experience another exacerbation at some point in the remainder of the study, compared with patients who were exacerbation-free in the first year.
Patients Want Better Allergy Medications
An Asthma and Allergy Foundation of America survey found that 31% of patients with allergies are not happy with their current prescription allergy medication. Of 1214 respondents, 60% also said that they were interested in finding a new prescription allergy medication.
Among the patients with allergies who are not fully satisfied with their current prescription medicine, 55% reported that they are not pleased because their allergy medication does not relieve their symptoms long enough. Nearly 44% are not satisfied because their medication does not provide symptom relief fast enough.
In addition, the survey revealed that 47% of patients with allergies take multiple allergy prescription medications, and 36% of the participants who take prescription allergy medication also reported using OTC allergy medication. The participants identified 3 important aspects of allergy prescription medication: that it be (1) long-lasting, (2) fast-acting, and (3) steroid-free.
One study linked multiple pregnancies to an increased risk of developing atrial fibrillation later in life, and another investigated the association between premature delivery and cardiovascular disease.
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