Academic literature on the topic 'Mini-Aqlq'

Antecedentes: El omalizumab es un anticuerpo monoclonal que controla los síntomas y reduce las exacerbaciones del asma alérgica grave.Objetivo: Analizar mediante el cuestionario mini-AQLQ y espirometría, la mejoría en la calidad de vida y función respiratoria con el omalizumab como complemento del tratamiento con corticosteroides inhalados y agonista beta-2 de acción prolongada.Métodos: De 30 pacientes con asma severa (90 % de mujeres y media de edad de 49.1 años), la evolución del diagnóstico de asma severa osciló entre uno y 24 años (promedio de 8.3 años). Todos presentaron al menos una prueba cutánea o IgE específica positiva a un aeroalérgeno, determinación de IgE total y espirometría. Al inicio y a las 52 semanas de aplicar el omalizumab (dosis promedio de 550 mg, con aplicación quincenal o mensual), se aplicó el mini-AQLQ y se obtuvo el volumen espiratorio forzado al primer segundo (VEF1).Resultados: Hubo mejoría significativa (p = 0.013) en el mini-AQLQ después de 52 semanas, con puntuación global de 4.5, principalmente en las dimensiones de emociones (p = 0.0073) y en la ambiental (p = 0.00014). No hubo cambios significativos del VEF1. En 63 % de los pacientes se observó obesidad y en 26 % sobrepeso.Conclusiones: El omalizumab mejoró la calidad de vida de los pacientes, sin cambios significativos del VEF1, probablemente por la obesidad.

Background. The primary goal of asthma management is to achieve good asthma control. However, poor patient-physician communication, unavailability of appropriate medications, and lack of long-term goals have made asthma control difficult in developing countries. Poor assessment of asthma control and quality of life is a major cause of suboptimal asthma treatment worldwide, and information regarding this issue is scanty in developing countries like Ethiopia. This study thus attempted to assess the level of asthma control and quality of life in asthmatic patients attending Armed Forces Referral and Teaching Hospital. Methods. A cross-sectional study comprising 184 physician-diagnosed asthmatic patients was conducted using interview, chart review, and prescription assessment. Asthma control was assessed using Asthma Control Test, while asthma quality of life was assessed using Mini-Asthma Quality of Life Questionnaire (mini-AQLQ). Spearman’s rank correlation analysis was performed to understand the relationship between mean mini-AQLQ score and asthma control. Receiver operating characteristic curve analysis was performed to establish cut-off values for mini-AQLQ. Results. Asthma was uncontrolled in 67.9% subjects. There was a strong correlation between asthma control and quality of life (rs=0.772; P<0.01). A cut-off value for the quality of life was established at 4.97. Majority of the patients were taking two or three antiasthmatic drugs. Oral tablet and inhaler short-acting beta agonists (SABA) were the frequently combined drugs. Uncontrolled asthma was associated with middle-aged adults (adjusted odds ratio AOR=6.31; 95% CI: 2.06, 19.3; P=0.001), male gender (AOR=0.38; 95% CI: 0.15, 0.98; P=0.044), married (AOR=0.24; 95% CI: 0.08, 0.78; P=0.017), comorbidities (AOR=0.23; 95% CI: 0.09, 0.61; P=0.003), and oral SABA use (AOR=0.22; 95% CI: 0.09, 0.59; P=0.003). Male gender (AOR=0.36; 95% CI: 0.16, 0.84; P=0.018), intermittent asthma (AOR=0.18; 95% CI: 0.04, 0.86; P=0.032), use of oral corticosteroids (AOR=0.22; 95% CI: 0.06, 0.73; P=0.013), and SABA (AOR=0.39; 95% CI: 0.17, 0.89; P=0.026) were found to have a significant association with poor asthma-related quality of life. Conclusion. The findings collectively indicate asthma remains poorly controlled in a large proportion of asthma patients in the study setting. Moreover, quality of life appears to be directly related to asthma control. Healthcare providers should therefore focus on asthma education with an integrated treatment plan to improve asthma control and quality of life.

Background For asthma strategy, to avoid the aggravation of bronchial inflammation and contraction, the long acting beta agonist (LABA) addition on inhaled corticosteroids (ICS) has been recommended. Objectives To know whether there is any clinical difference between the additional efficacies of Formoterol (FOR) and Tulobuterol (TUL) onto Budesonide (BUD) may be useful for the elderly patients’ asthma treatment strategy. Methods Eighteen outpatients with mild to moderate bronchial asthma with FEV1.0% < 80% treated by intermediate ICS dosages visited Respiratory Division of Nagasaki University Hospital or Isahaya General Hospital, Japan Community Health care Organization were subjected, and were randomly assigned (9 cases per group) to either the FBC group (BUD/FOR 160/4.5 µg, 2 inhalations twice daily) or BUD + TUL group (BUD 200 mcg: 2 inhalations twice daily + TUL 2 mg daily) and were compared in parallel with 2 arms for 12 weeks prospectively. Peak expiratory flow, forced expiratory volume in 1 second, impulse oscillometry (IOS), fractional exhaled nitric oxide (FeNO), Asthma Control Questionnaire, mini-Asthma Quality of Life Questionnaire (mini-AQLQ), and occurrence of adverse reactions were compared. Results The “Fres” of IOS was improved in FBC group (p = 0.03). The “emotion” domain of mini-AQLQ was improved in BUD + TUL group (p = 0.03). Conclusion By changing the drug formulation, the patch was superior in terms of satisfaction, but it was thought that the inhaled combination was superior in improving the respiratory function itself. It is necessary to pay attention to the characteristics of the patient when selecting treatment.

Purpose. Asthma is a chronic disease which cannot be cured but can be controlled. Although drug therapy is used to relieve and prevent symptoms of asthma and treat exacerbations, still a good asthma control and a better quality of life in many patients is suboptimal due to improper use of inhalation technique. Thus, this interventional study was conducted to evaluate the effect of a pharmacist intervention on asthma control, quality of life and inhaler technique in adult asthmatic patients. Patients and Methods. A total of 72 patients who met the inclusion criteria and agreed to give written consent were enrolled in the study. These patients were randomly divided into two groups i.e., test group (36) and control group (36) by simple block randomization technique. Test group were the interventional groups. Mini Asthma Quality of Life Questionnaire (AQLQ), Asthma Control Questionnaire (ACQ) and structured questionnaires were used to sort the information like quality of life, asthma control and demographic details. They were counselled by the pharmacist about the asthma management and proper use of inhalers. Out of 72 patients, only forty six patients came for follow up after one month. Data were entered and analyzed using Statistical Package for Social Sciences (SPSS) software version 20. Results. A significant change was observed in the mean score of quality of life (p=0.001) in test group as well as control group, however change in the mean score of asthma control in the test group (p=0.001) was more significant as compared to the control group (p=0.099). Inhalation technique was found to be improved significantly after intervention among patients using the metered dose inhaler and dry powder inhaler. Majority of the patients were prescribed with Methylxanthines (24.5%) followed by combined Beta 2 agonists and Inhaled Corticosteroids (21.7%). Conclusion. Pharmacist provided intervention improves the quality of life, asthma control and inhalation technique among asthmatic patients.

BackgroundBacterial infections are implicated in the pathogenesis of asthma exacerbation but guidelines recommend that antibiotics should not be administered. Telithromycin shows clinical benefit compared with placebo but toxicity limits its use.ObjectiveTo evaluate the efficacy of azithromycin compared with placebo in reducing the severity of asthma exacerbations.DesignMulticentre, randomised, double-blind, placebo-controlled study.SettingAccident and emergency and acute medical units, and one primary care centre.ParticipantsAdults with a history of asthma presenting within 48 hours (of initial presentation requesting medical care) with an acute deterioration in asthma control [increased wheeze, dyspnoea and/or cough with reduced peak expiratory flow (PEF)] requiring treatment with corticosteroids.InterventionsAzithromycin (500 mg once daily) or two placebo capsules once a day for 3 days.Main outcome measureDiary card summary symptom score assessed at 10 days after randomisation.ResultsIn total, 4582 patients were screened at 31 centres, of whom 199 were randomised to the study (azithromycin,n = 97; placebo,n = 102) (of the intended 380). The major reasons for non-recruitment were already receiving antibiotics (n = 2044; 44.6% of screened subjects), unable to contact (n = 315; 6.9%), declined participation (n = 191; 4.2%) and other (e.g. underlying health condition, on steroids;n = 1833; 40.0%). The mean age of participants was 39.9 years and 69.8% were female; 61.1% had never smoked, 22.7% were former smokers and 16.2% were current smokers (mean pack-years 3.45). The median time from presentation to drug administration was 22 hours. Lung function at baseline (exacerbation) was PEF 69.4% predicted, forced expiratory volume in 1 second (FEV1) 64.8% predicted and FEV1/forced vital capacity ratio 69.2%. Baseline characteristics were well balanced across treatment arms and centres. The mean (standard deviation) scores on the primary outcome asthma symptom score were 4.14 (1.38) at baseline and 2.09 (1.71) at the end of treatment for the azithromycin group, and 4.18 (1.48) at baseline and 2.20 (1.51) at the end of treatment for the placebo group. Using multilevel modelling there was no statistically significant difference in symptom scores between groups at day 10 (unbiased estimated mean difference –0.166, 95% confidence interval –0.670 to 0.337); similarly, no significant between-group differences were seen in symptom scores on any other day between baseline and day 10. No significant between-group differences were seen in the Acute Asthma Quality of Life Questionnaire (AQLQ) score, Mini AQLQ score or any measure of lung function on any day, and there were no differences in time to a 50% reduction in symptom score. Sputum bacterial culture was positive in 6% of subjects, atypical pathogen polymerase chain reaction (PCR) and/or serology was positive in 4.5% of subjects and virus PCR analysis was positive in 18.1% of subjects. There was no difference in the primary outcome between the active group and the placebo group among those with a positive sputum bacterial test, although numbers for these analyses were small.ConclusionsIn the population of patients randomised to treatment, the addition of azithromycin to standard medical care demonstrated no statistically significant or clinically important benefit, although this could not be ruled out based on the confidence intervals. A limitation of this study was that, for each subject randomised, > 10 failed screening because they had already been prescribed antibiotic therapy. Further clinical trials are needed in settings of less antibiotic usage.Trial registrationClinicalTrials.gov NCT01444469; EudraCT 2011–001093–26.FundingThis project was funded by the Efficacy and Mechanism Evaluation programme, a Medical Research Council and National Institute for Health Research partnership.

Abstract Background Severe asthma affects a small population but carries a high psychopathological risk. Therefore, the psychodemographic profile of these patients is of interest. A substantial prevalence of anxiety, depression, alexithymia and hyperventilation syndrome in severe asthma is known, but contradictory results have been observed. These factors can also affect patients’ quality of life. For this reasons, our purpose is to evaluate the psychodemographic profile of patients with severe asthma and assess the prevalence of anxiety, depression, alexithymia and hyperventilation syndrome and their impact on the quality of life of patients with severe asthma. Methods A cross-sectional study of 63 patients with severe asthma. Their psychodemographic profile was evaluated using the Hospital Anxiety and Depression Scale (HADS), Toronto Alexithymia Scale (TAS-20), Nijmegen questionnaire and Asthma Control Test (ACT) to determine the state of anxiety and depression, alexithymia, hyperventilation syndrome and control of asthma, respectively. Quality of life was assessed with the Mini Asthma Quality of Life Questionnaire (Mini-AQLQ). Results The mean age was 60 ± 13.6 years. Personal psychopathological histories were found in 65.1% of participants, and 8% reported previous suicidal attempts. The rate of anxiety and/or depression (HADS ≥ 11) was 68.3%. These patients present higher scores on the TAS-20 (p < 0.001) for the level of dyspnea (p = 0.021), and for emotional function (p = 0.017) on the Mini-AQLQ, compared with patients without anxiety or depression. Alexithymia (TAS-20 ≥ 61) was observed in 42.9% of patients; these patients were older (p = 0.037) and had a higher HADS score (p = 0.019) than patients with asthma without alexithymia. On the other hand, patients with hyperventilation syndrome (Nijmegen ≥ 23) scored higher on the HADS (p < 0.05), on the Mini-AQLQ (p = 0.002) and on the TAS-20 (p = 0.044) than the group without hyperventilation syndrome. Quality of life was related to anxiety-depression symptomatology (r = − 0.302; p = 0.016) and alexithymia (r = − 0.264; p = 0.036). Finally, the Mini-AQLQ total score was associated with the Nijmegen questionnaire total score (r = − 0.317; p = 0.011), and the activity limitation domain of the Mini-AQLQ correlated with the ACT total score (r = 0.288; p = 0.022). Conclusions The rate of anxiety, depression, alexithymia and hyperventilation syndrome is high in patients with severe asthma. Each of these factors is associated with a poor quality of life.

AbstractThe aim of this study was to identify asthma phenotypes through cluster analysis. Cluster analysis was performed using self-reported characteristics from a cohort of 1291 Swedish asthma patients. Disease burden was measured using the Asthma Control Test (ACT), the mini Asthma Quality of Life Questionnaire (mini-AQLQ), exacerbation frequency and asthma severity. Validation was performed in 748 individuals from the same geographical region. Three clusters; early onset predominantly female, adult onset predominantly female and adult onset predominantly male, were identified. Early onset predominantly female asthma had a higher burden of disease, the highest exacerbation frequency and use of inhaled corticosteroids. Adult onset predominantly male asthma had the highest mean score of ACT and mini-AQLQ, the lowest exacerbation frequency and higher proportion of subjects with mild asthma. These clusters, based on information from clinical questionnaire data, might be useful in primary care settings where the access to spirometry and biomarkers is limited.

Background: Asthma is a common chronic inflammatory disease of the airways affecting 3 millionCanadians. Primary Care Providers (PCPs) are integral to care coordination, enhanced through thedevelopment of a strong patient-PCP relationship with Continuity of Care (COC). A recent CIHI studynoted that 40% of Albertans do not have a COC model for primary care.Objectives: We aim to evaluate how primary care for adults with asthma impacts different measures ofcontrol.Methods: Prospective population-based recruitment of adults through various community venuesacross Alberta. Those who had self-reported asthma and were willing to participate completed a surveywhich included demographics, comorbidities, medication use (including biologics, allergy medications,steroids), Asthma Control Questionnaire (ACQ-5), Asthma Control Test (ACT), Quality of Life (QoL)measured through the mini-Asthma Quality of Life Questionnaire (mini-AQLQ) and health care utilization(including Emergency Department (ED) visits, hospitalizations and ICU stays for asthma).Results: Of the 1685 individuals approached, 61 (3.6%) reported having asthma, of which 47 lived inAlberta. Most (41, 87%) had a PCP, with 30 (64%) visiting their PCP at least twice a year. Uncontrolledasthma was noted in 21 (45%) with either the ACQ-5 or ACT. The mini-AQLQ indicated 5 (11%) withreduced QoL. Mean lifetime hospitalizations, lifetime Emergency Department (ED) visits, and ICU staysrelated to asthma were 1.52, 4.55 and 0.25 respectively. Further, mean hospitalizations and ED visits inthe past 12 months related to asthma were 0.05 and 0.30 respectively.Conclusions: Asthma control was poor in 21 (45%) surveyed individuals, suggesting sub-optimal asthmamanagement in Alberta. Knowledge of Primary Care Networks (PCNs) was low, while ED and hospitalusage was high.

O estágio curricular, realizado no final do Mestrado Integrado em Ciências Farmacêuticas, surge como uma oportunidade de consolidar os conhecimentos adquiridos ao longo da formação académica e contactar com a realidade farmacêutica, permitindo a aquisição de novos conhecimentos nas várias vertentes da farmácia, sendo os quais uma mais-valia, como futura profissional de saúde. Desta forma, este trabalho, no qual descreve a minha experiência profissionalizante, encontra-se dividido em três partes distintas, sendo que a primeira incide sobre a vertente de investigação desenvolvida, outra referente ao relatório de estágio em Farmácia Hospitalar e, uma terceira parte relativa ao relatório em Farmácia Comunitária. Em relação à vertente de investigação, atendendo que a asma e a doença pulmonar obstrutiva crónica são duas patologias com elevada prevalência e impacto na qualidade de vida tanto dos doentes como das famílias, o principal objetivo deste estudo foi avaliar a qualidade de vida dos doentes com asma e/ou DPOC em contexto de Farmácia Comunitária. Para tal, foram aplicados três instrumentos de avaliação, sendo eles: um questionário base, com o qual foi possível distinguir entre utentes com asma e/ou DPOC (auto reportado pelo doente) e recolher alguns dados demográficos e clínicos, e dois instrumentos validados de autopreenchimento, em que se utilizaram o teste “Mini Asthma Quality of Life Questionnaire (Mini-AQLQ), e o teste COPD Assessment TestTM (CAT). Este estudo transversal observacional foi realizado entre Dezembro de 2013 e Abril de 2014 em farmácias comunitárias de Barcelos e Esposende e utilizou uma amostra de conveniência de doentes com idade superior a 40 anos e que, em nome próprio, apresentassem uma receita médica que incluísse medicação específica para a asma e/ou DPOC. Foram convidados a participar 380 utentes, dos quais 71 aceitaram mas apenas 66 preencheram os critérios de inclusão. Dos utentes inquiridos 37 doentes auto relataram apenas asma, 18 apenas DPOC e 11 ambas as patologias. A análise dos dados foi realizada na folha de cálculo Microsoft Excel® e através do software informático “Statistical Package for the Social Sciences” (SPSS), versão 20.0 for Windows®, através dos quais se aplicaram os testes apropriados consoante as análises a efetuar. A avaliação das correlações entre a pontuação total dos dois questionários com as variáveis em estudo foi realizada com o Coeficiente de Correlação Linear de Pearson, no qual foi considerado um nível de significância de p=0,05. No que diz respeito aos resultados, para a asma, no Mini-AQLQ obteve-se uma pontuação média de 4,270, em que o domínio “ambiente” (3,450) e o domínio da “limitação das atividades” (4,410) representam, respetivamente, o maior e o menor impacto na qualidade de vida dos doentes asmáticos. Os valores obtidos no teste apresentaram-se estatisticamente relacionados com a variável “idade” (p=0,048) e com a variável “trabalha/ou em minas ou com produtos químicos” (p=0,034), estando associados a uma pior qualidade de vida. Em relação à DPOC, a pontuação média obtida no CAT foi de 21,13, ou seja, em média a patologia apresenta um alto nível de impacto na qualidade de vida da população em estudo. Os valores do CAT mostraram-se estatisticamente relacionados com as variáveis: “idade” (p=0,045), “trabalha/ou em minas ou com produtos químicos” (p=0,048), “exposto regularmente a fumos da lareira” (p=0,051) e com a variável “fumador” (p=0,032), estando associados a uma pior qualidade de vida. Em suma, tanto a asma como a DPOC têm um elevado impacto na qualidade de vida, sendo este maior quando as doenças são concomitantes. Tanto num caso como no outro, os idosos e aqueles que tinham trabalhado em minas ou com produtos químicos tinham uma qualidade de vida pior. Outros aspetos sociodemográficos não demonstraram impacto significativo. Relativamente ao estágio em Farmácia Hospitalar, este foi realizado no Centro Hospitalar da Cova da Beira, entre 9 de setembro e 1 de novembro de 2013, sob orientação da Prof.ª Olímpia Fonseca. Neste relatório pretendo descrever o funcionamento e organização da farmácia hospitalar, as diversas atividades que acompanhei e realizei nas diferentes áreas bem como as competências técnicas que adquiri. Por último, o estágio em Farmácia Comunitária foi realizado na Farmácia Rosmaninho, em Barcelos, entre os dias 11 de novembro de 2013 e 31 de janeiro de 2014, sob orientação da Dra. Ana Filipa Rosmaninho. Neste presente relatório pretendo descrever as distintas funções, nas quais tive oportunidade de acompanhar e assumir uma posição ativa bem como o funcionamento de uma farmácia comunitária e todas as tarefas e responsabilidades inerentes.
The internship, which takes place at the end of the MSc in Pharmaceutical Sciences, is an opportunity to consolidate the knowledge acquired throughout the course, and to get in touch with the professional reality, which in turn allows additional learning related to the several aspects in pharmacy, an appreciation as a future healthcare professional. Therefore, this paper which describes my experience is divided into three separate parts, being the first the investigation I carried out in the last months, and the second and third the Hospital Pharmacy and Community Pharmacy Internship essays, respectively. In what concerns to the investigation component, knowing that asthma and COPD are two diseases with high prevalence and impact in either the patients or families lives, the major aim of this study was to access the patients quality of life in community pharmacy. In order to accomplish this aim three instruments were applied, namely a base questionnaire which allowed differentiating patients with asthma and/or COPD (self-reported by the patient) and collecting demographic and clinical data, and two validated instruments in which the Mini Asthma Quality of Life Questionnaire (Mini-AQLQ) and the COPD Assessment TestTM (CAT) were used. This cross-sectional study was carried out between December 2013 and April 2014 in Esposende and Barcelos community pharmacies and used a convenience sample of patients over 40 years old who presented a prescription including specific asthma and/or COPD medication. 380 patients were invited to participate but only 71 accepted. Of these, 66 met the inclusion criteria. Of those who were surveyed, 37 reported only asthma, 18 reported only COPD and 11 reported both diseases. The data analysis was performed through computer software Microsoft Excel® and “Statistical Package for the Social Sciences” (SPSS), version 20.0 for Windows®. The evaluation of correlations between the total scores in the questionnaires and the variables was performed using the Pearson product-moment correlation coefficient, in which a statistical significance of p=0,05 was considered. In what is concerned to results, for asthma a mean score of 4,270 was obtained in the Mini-AQLQ, in which the field “environment” (3,450) and the field “activity limitation” (4,410) represented the major and the minor impact in the asthmatic patients’ quality of life, respectively. The values obtained were statistically related to the variables “age” (p=0,048) and “work/ed in mines or with chemical products” (p=0,034), and are associated with a worse quality of life. For COPD a mean score of 21,13 was obtained in the CAT, that is, in average this disease represents a high level of impact in this population’s quality of life. The CAT scores were statistically related to the variables “age” (p=0,045), “work/ed in mines or with chemical products” (p=0,048), “often exposed to fireplace fumes” (p=0,051) and “smoker” (p=0,032), and are associated with a worse quality of life. In summary, both asthma and COPD have a high impact in the quality of life, and this impact is higher when the diseases are concomitant. In either case, the elderly and those who had worked in mines or with chemical products had a worse quality of life. Other social and demographic aspects did not show a significant impact. The Hospital Pharmacy Internship took place in Centro Hospitalar da Cova da Beira, between 9th September 2013 and 1st November 2013, under the supervision of Dr. Olímpia Fonseca. In this report I will describe the functioning and organization of a Hospital Pharmacy, the various activities that I followed and performed in the different sectors, as well as the technical skills I developed. Lastly, the Community Pharmacy Internship took place in Farmácia Rosmaninho, in Barcelos, between 11th November 2013 and 31st January 2014, under supervision of Dr Ana Filipa Rosmaninho. In this report I will describe the different functions I had opportunity to follow and take part as well as the functioning of a community pharmacy and all the related tasks and responsabilities.