GINA Implementation Improves Asthma Symptoms Control and Lung Function: A Five-Year Real-World Follow-Up Study
Abstract
:1. Introduction
2. Patients and Methods
2.1. Study Design and Setting
2.2. Patients
2.3. Data Collection
2.4. Statistical Analysis
3. Results
3.1. Baseline Characteristics
3.2. Level of Asthma Symptoms Control
3.3. Lung Function
3.4. ICS Dosage and Rate of Follow-Up Visits
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Baseline Characteristics | |
---|---|
Age (years): mean ± SD (n = 1388) | 40.0 ± 16.7 |
Female (n = 1388) | 897 (64.6%) |
Education level (n = 106) | |
High school degree or higher | 72 (67.9%) |
Smoking status (n = 1386) | |
Smokers | 160 (11.5%) |
Non-smokers | 1226 (88.5%) |
Comorbidities | |
Allergic rhinitis (n = 1388) | 357 (25.7%) |
BMI ≥ 25 kg/m2 (n = 1388) | 206 (14.8%) |
Gastroesophageal reflux (n = 1386) | 178 (12.8%) |
Childhood asthma (n = 1387) | 408 (29.4%) |
BMI (kg/m2) (n = 1386) | 21.7 ± 3.5 |
Spirometry results (n = 1388) | |
FVC (% predicted) | 84.6 ± 16.9 |
FEV1 (% predicted) | 77.5 ± 20.8 |
PEF (% predicted) | 67.8 ± 22.4 |
Positive bronchodilator reversibility test (n = 1377) * | 773 (56.1%) |
Asthma severity (n = 1354) † | |
Intermittent asthma | 7 (0.5%) |
Mild persistent asthma | 85 (6.3%) |
Moderate persistent asthma | 281 (20.8%) |
Severe persistent asthma | 981 (72.4%) |
Level of asthma symptoms control (n = 1329) § | |
Well-controlled | 35 (2.6%) |
Partly controlled | 369 (27.8%) |
Uncontrolled | 925 (69.6%) |
Asthma controllers prescribed (n = 1388) | |
ICS/LABA | 1343 (96.8%) |
Montelukast | 849 (61.2%) |
LAMA | 7 (0.5%) |
ICS molecules (n = 1360) | |
Fluticasone propionate | 919 (67.6%) |
Budesonide | 441 (32.4%) |
Co-paid by health insurance (n = 1353) | 324 (23.9%) |
Visits | Baseline (n = 1377) | Year 1 (n = 777) | Year 2 (n = 433) | Year 3 (n = 308) | Year 4 (n = 197) | Year 5 (n = 128) |
---|---|---|---|---|---|---|
Hospitalizations | 0.056 ± 0.301 | 0.003 ± 0.051 | 0.002 ± 0.048 | 0.0 ± 0.0 | 0.005 ± 0.071 | 0.016 ± 0.124 |
p value * | <0.0001 | 0.0001 | 0.0005 | 0.0049 | 0.1484 | |
Exacerbations | 0.120 ± 0.544 | 0.069 ± 0.264 | 0.060 ± 0.238 | 0.081 ± 0.285 | 0.056 ± 0.230 | 0.055 ± 0.228 |
p value * | 0.0885 | 0.0283 | 0.6576 | 0.0309 | 0.0340 |
Spirometry Parameters | Baseline n = 1388 | Year 1 n = 556 | Year 2 n = 341 | Year 3 n = 239 | Year 4 n = 165 | Year 5 n = 107 |
---|---|---|---|---|---|---|
FVC, % predicted * | 84.6 ± 16.9 | 91.1 ± 14.3 (p < 0.0001) | 91.1 ± 15.2 (p < 0.0001) | 91.0 ± 14.8 (p < 0.0001) | 90.7 ± 14.5 (p < 0.0001) | 90.1 ± 14.5 (p < 0.0001) |
FEV1, % predicted * | 77.5 ± 20.8 | 86.3 ± 17.4 (p < 0.0001) | 86.2 ± 17.4 (p < 0.0001) | 85.6 ± 18.2 (p < 0.0001) | 85.9 ± 16.9 (p < 0.0001) | 85.7 ± 16.7 (p < 0.0001) |
FEV1/FVC * | 75.7 ± 12.6 | 78.5 ± 10.3 (p < 0.0001) | 77.8 ± 10.3 (p = 0.0080) | 77.5 ± 10.8 (p < 0.0001) | 77.8 ± 11.0 (p = 0.0384) | 77.5 ± 10.2 (p = 0.1714) |
PEF, % predicted * | 67.8 ± 22.4 | 82.1 ± 19.7 (p < 0.0001) | 81.5 ± 19 (p < 0.0001) | 81.0 ± 19.5 (p < 0.0001) | 81.3 ± 18.0 (p < 0.0001) | 81.6 ± 16.5 (p < 0.0001) |
Baseline Characteristics | Follow-Up Visit at Year 1 | Adjusted OR (95% CI) | p | |
---|---|---|---|---|
Other provinces (n = 932) vs. Ho Chi Minh City (n = 456) | 537 (57.6%) | 232 (50.9%) | 1.26 (1.00–1.60) | 0.0527 |
Allergic rhinitis (n = 357) vs. no allergic rhinitis (n = 1031) | 220 (61.6%) | 549 (53.3%) | 1.40 (1.09–1.81) | 0.0092 |
BMI < 25 kg/m2 (n = 1182) vs. BMI ≥ 25 kg/m2 (n = 206) | 670 (56.7%) | 99 (48.1%) | 1.20 (0.88–1.64) | 0.2479 |
Co-pay (n = 324) vs. non-co-pay (n = 1029) | 197 (60.8%) | 561 (54.5%) | 1.25 (0.96–1.62) | 0.0957 |
Fluticasone (n = 919) vs. Budesonide (n = 441) | 534 (58.1%) | 224 (50.8%) | 1.21 (0.95–1.54) | 0.1244 |
High-dose ICS (n = 1050) vs. non-high-dose ICS (n = 275) | 606 (57.7%) | 141 (51.3%) | 1.18 (0.89–1.56) | 0.2497 |
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Tho, N.V.; Quan, V.T.T.; Dung, D.V.; Phu, N.H.; Dinh-Xuan, A.T.; Lan, L.T.T. GINA Implementation Improves Asthma Symptoms Control and Lung Function: A Five-Year Real-World Follow-Up Study. J. Pers. Med. 2023, 13, 809. https://doi.org/10.3390/jpm13050809
Tho NV, Quan VTT, Dung DV, Phu NH, Dinh-Xuan AT, Lan LTT. GINA Implementation Improves Asthma Symptoms Control and Lung Function: A Five-Year Real-World Follow-Up Study. Journal of Personalized Medicine. 2023; 13(5):809. https://doi.org/10.3390/jpm13050809
Chicago/Turabian StyleTho, Nguyen Van, Vu Tran Thien Quan, Do Van Dung, Nguyen Hoang Phu, Anh Tuan Dinh-Xuan, and Le Thi Tuyet Lan. 2023. "GINA Implementation Improves Asthma Symptoms Control and Lung Function: A Five-Year Real-World Follow-Up Study" Journal of Personalized Medicine 13, no. 5: 809. https://doi.org/10.3390/jpm13050809