ABSTRACT
Background@#In China, the prevalence of allergic rhinitis (AR) and asthma has increased in the past decade. As these two diseases frequently coexist, the Asia-Pacific Survey of Physicians on Asthma and Allergic Rhinitis (ASPAIR) study aimed to assess physicians’ beliefs and treatment patterns of coexistent asthma-AR across six Asian countries. This analysis presents the results from China.@*Methods@#The 200 hospital-based general physicians and pediatricians were interviewed from five cities in China. Physicians were questioned in-person about their knowledge, beliefs and management practices for patients with coexistent asthma-AR.@*Results@#Approximately 70% of the physicians interviewed routinely evaluated their patients with asthma or AR for signs of coexistent disease. While the majority of physicians (>90% of physicians) recognized the increased burden of coexistent asthma-AR vs. one condition alone and that coexistent disease requires additional treatment, most physicians (96%) also believed that patients with coexistent asthma-AR were well managed if either condition alone improved. Similarly, although 71% of physicians selected a combination of intranasal and inhaled corticosteroids as their preferred treatment for coexistent asthma-AR, in line with treatment guidelines, two fifths of physicians indicated that treatment for coexistent disease requires too much medication and that their patients prefer oral medications and a third of physicians believed that corticosteroids should be delayed in children.@*Conclusions@#This survey demonstrates that physicians interviewed in China have a broad understanding of coexistent asthma-AR and its impact on patients. A holistic approach to patient management with informed decisions regarding patients’ overall treatment will benefit patients who suffer from coexistent disease.
ABSTRACT
BACKGROUND@#In China, the prevalence of allergic rhinitis (AR) and asthma has increased in the past decade. As these two diseases frequently coexist, the Asia-Pacific Survey of Physicians on Asthma and Allergic Rhinitis (ASPAIR) study aimed to assess physicians' beliefs and treatment patterns of coexistent asthma-AR across six Asian countries. This analysis presents the results from China.@*METHODS@#The 200 hospital-based general physicians and pediatricians were interviewed from five cities in China. Physicians were questioned in-person about their knowledge, beliefs and management practices for patients with coexistent asthma-AR.@*RESULTS@#Approximately 70% of the physicians interviewed routinely evaluated their patients with asthma or AR for signs of coexistent disease. While the majority of physicians (>90% of physicians) recognized the increased burden of coexistent asthma-AR vs. one condition alone and that coexistent disease requires additional treatment, most physicians (96%) also believed that patients with coexistent asthma-AR were well managed if either condition alone improved. Similarly, although 71% of physicians selected a combination of intranasal and inhaled corticosteroids as their preferred treatment for coexistent asthma-AR, in line with treatment guidelines, two fifths of physicians indicated that treatment for coexistent disease requires too much medication and that their patients prefer oral medications and a third of physicians believed that corticosteroids should be delayed in children.@*CONCLUSIONS@#This survey demonstrates that physicians interviewed in China have a broad understanding of coexistent asthma-AR and its impact on patients. A holistic approach to patient management with informed decisions regarding patients' overall treatment will benefit patients who suffer from coexistent disease.
ABSTRACT
BACKGROUND: Underdiagnosis and undertreatment of allergic rhinitis (AR) in patients with asthma can worsen treatment outcomes. There is limited evidence of clinical practices for management of coexistent AR-asthma in Thailand. METHODS: A multicountry, cross-sectional study (Asia-pacific Survey of Physicians on Asthma and allergic Rhinitis) to evaluate physician perceptions and management practices related to AR-asthma overlap in 6 Asian countries was conducted. For Thailand specifically, AR-asthma linkage questionnaires were developed and translated to Thailaland. General physicians (GPs) or pediatricians, randomly selected from hospitals in urban cities, routinely treating >10 asthma patients/month were interviewed. Here we present the results for Thailand. RESULTS: Two hundred physicians (100 GPs and 100 pediatricians), of whom 70% worked in government hospitals, were interviewed. In their experience, 50% of asthma patients had AR and 28% of AR patients had asthma. Among diagnosed asthma patients, 65% of physicians routinely asked for any AR symptoms at every visit. Among diagnosed AR patients, 63% of physicians routinely asked for any asthma symptoms at every visit. In patients with coexisting AR-asthma, 91% of physicians treated both diseases simultaneously, while 6% of physicians treated asthma as a chronic disease but managed AR symptomatically. The most preferred treatment options for patients with AR-asthma were inhaled corticosteroids with intranasal steroids (46% in GPs, 71% in pediatricians). CONCLUSION: The physicians interviewed in Thailand are aware about coexistent asthma-AR. There is a need to increase the awareness further for coexistent AR-asthma and to educate nonspecialist physicians in the proper management of AR-asthma patients.
Subject(s)
Humans , Adrenal Cortex Hormones , Asian People , Asthma , Chronic Disease , Comorbidity , Cross-Sectional Studies , Rhinitis, Allergic , Steroids , ThailandABSTRACT
To evaluate the influence of thoracic spine curvature on lung parameters in kyphoscoliosis. Twenty-one patients with kyphoscoliosis were evaluated at the Vallabhbhai Patel Chest Institute, Delhi, India from January to June 2006 using spirometry, arterial blood gas [ABG], and 6-minute walk test. The degree of spinal deformity was measured by Cobb's method for angle of scoliosis and angle of kyphosis. There were 13 males and 8 females [mean age 47.38 +/- 20.10 years]. Decreased lung volumes, hypoxemia, arterial oxygen desaturation, and decreased exercise capacity was observed in patients with kyphoscoliosis. The angle of scoliosis ranged from 60-126° [78.1 +/- 18.3] and angle of kyphosis ranged from 5-48° [18.05 +/- 10.5]. The forced vital capacity [FVC] was 1.92 +/- 0.8 L [0.66-3.44], and the forced expiratory volume in one second [FEV1] was 1.51 +/- 0.5 L [0.6-2.6]. The FEV1/FVC was 60.9 +/- 12.9 [42-86%]. The partial arterial oxygen tension was 51.7 +/- 6.9 Hg. The partial pressure of carbon dioxide in arterial blood was 49.85 +/- 7.9 mm Hg. The functional oxygen saturation was 84 +/- 3.7%. No correlation was found between pulmonary function test [PFT] or ABG values with the degree of spinal deformity. Mean oxygen desaturation [87.48-84.43%] and rise in systolic blood pressure [118.48-126.67 mm Hg] during walk test correlated well with degree of spinal deformity. The severity of pulmonary impairment could not be inferred from the angle of scoliosis alone. The 6-minute walk test gives an early indication of limitations and correlates well with structural deformity. The PFT and ABG parameters do not correlate well with the severity of deformity. Thus, the 6-minute walk test must be included in the thorough evaluation of all patients with kyphoscoliosis