Asthma control in Europe: a real-world evaluation based on an international population-based study.

• Published in: Journal of Allergy and Clinical Immunology
• Main Authors: Cazzoletti, Lucia, Marcon, Alessandro, Janson, Christer, Corsico, Angelo, Jarvis, Deborah, Pin, Isabelle, Accordini, Simone, Almar, Enrique, Bugiani, Massimiliano, Carolei, Adriana, Cerveri, Isa, Duran-Tauleria, Enric, Gislason, David, Gulsvik, Amund, Jõgi, Rain, Marinoni, Alessandra, Martínez-Moratalla, Jesús, Vermeire, Paul, de Marco, Roberto
• Other Authors: Department of Diagnostics and Public Health Verona (UNIVR, Università degli studi di Verona = University of Verona (UNIVR), Department of Medical Sciences, Respiratory Medicine & Allergology, Uppsala University, Division of Respiratory Diseases, Università degli Studi di Pavia = University of Pavia (UNIPV)-San Matteo Hospital, Respiratory Epidemiology and Public Health Group, Imperial College London-National Heart and Lung Institute UK, Service de pédiatrie générale et maladies infectieuses, CHU Grenoble, Institut d'oncologie/développement Albert Bonniot de Grenoble (INSERM U823), Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM), Servicio de Neumología, Complejo Hospitalario Universitario de Albacete-Servicio de Salud de Castilla-La Mancha, Unit of Pneumology, Consorzio Provinciale Antitubercolare, Department of Applied Health Sciences, Università degli Studi di Pavia = University of Pavia (UNIPV), IMIM-Hospital del Mar, Generalitat de Catalunya, Department of Allergy, Respiratory Medicine and Sleep, Landspitali University Hospital, Department of Thoracic Medicine Bergen, Haukeland University Hospital, University of Bergen (UiB)-University of Bergen (UiB), Foundation Tartu University Clinics, Lung Clinic, Campus Drie Eiken, University of Antwerp (UA)
• Format: Article in Journal/Newspaper
• Language: English
• Published: HAL CCSD 2007
• Subjects: MESH: Adult; MESH: Allergens; MESH: Practice Guidelines as Topic; MESH: Prevalence; MESH: Questionnaires; MESH: Randomized Controlled Trials as Topic; MESH: Risk Factors; MESH: Severity of Illness Index; MESH: Animals; MESH: Asthma; MESH: Cross-Sectional Studies; MESH: Disease Management; MESH: European Union; MESH: Female; MESH: Humans; MESH: Male; [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie; Iceland
• Online Access: https://www.hal.inserm.fr/inserm-00348823; https://doi.org/10.1016/j.jaci.2007.09.019

International audience BACKGROUND: Epidemiologic evidence related to asthma control in patients from the general population is scanty. OBJECTIVES: We sought to assess asthma control in several European centers according to the Global Initiative for Asthma (GINA) guidelines and to investigate its determinants. METHODS: In the European Community Respiratory Health Survey II (1999-2002), 1241 adults with asthma were identified and classified into inhaled corticosteroid (ICS) users and non-ICS users in the last year. Control was assessed in both groups by using the GINA proposal (controlled, partly controlled, and uncontrolled asthma), and it was related to potential determinants. RESULTS: Only 15% (95% CI, 12% to 19%) of subjects who had used ICSs in the last year and 45% (95% CI, 41% to 50%) of non-ICS users had their asthma under control; individuals with uncontrolled asthma accounted for 49% (95% CI, 44% to 53%) and 18% (95% CI, 15% to 21%), respectively. Among ICS users, the prevalence of uncontrolled asthma showed great variability across Europe, ranging from 20% (95% CI, 7% to 41%; Iceland) to 67% (95% CI, 35% to 90%; Italy). Overweight status, chronic cough and phlegm, and sensitization to Cladosporium species were associated with poor control in ICS users. About 65% and 87% of ICS users with uncontrolled and partly controlled asthma, respectively, were on a medication regimen that was less than recommended by the GINA guidelines. CONCLUSION: Six of 7 European asthmatic adults using ICSs in the last year did not achieve good disease control. The large majority of subjects with poorly controlled asthma were using antiasthma drugs in a suboptimal way. A wide variability in asthma control emerged across Europe. CLINICAL IMPLICATIONS: Greater attention should be paid to asthma management and to the implementation of the GINA guidelines.