ABSTRACT
Background: In March 2020, the state of alarm was declared in Spain due to the health crisis caused by SARS-COV-2. The rapid spread of the virus generated uncertainty and concern about the impact it could have on patients with severe asthma (SA) and boosted for the first time the use of teleconsultation for the management of these patients. For this reason, it was necessary to facilitate the transition to a hybrid model that combines face-to-face and digital consultations. Objective(s): Development of the first document designed for SA patients, aimed to support the preparation of the telematic follow-up consultations with their specialist. Method(s): Nine experts in SA from different specialties: 4 allergists, 3 pulmonologists and 2 asthma unit nurses contributed to the conceptualization and development of the document. In a first phase of conceptualization, the profile of patients to which the material is addressed was defined and the minimum content needed to be useful to both patients and healthcare professionals (HCPs) was established. A first draft was prepared and refined after evaluation by adult patients and parents of pediatric patients through cognitive interviews. Result(s): Onasm@ is the first document intended for SA patients to prepare the telematic follow-up consultation with their specialist. It consists of three blocks: A first one with general considerations to be applied on the telematic consultation, a second one to collect all the information that might be requested by the healthcare professional (HCP) during the off-site visit (asthma medications, dosage, adherence, asthma crisis events, emergency visits and oral corticosteroid use) and the third block with tips for achieving and maintaining asthma control. The asthma control test (ACTTM) for adults and the children's version (cACTTM) is also incorporated. Conclusion(s): The transition to a hybrid healthcare model due to the pandemic situation makes it essential to support SA patients to face the telematic follow-up consultation with their specialist. Onasm@ is the first document designed to help patients to appreciate the information needed to face this type of visit, with the aim to promote a fluid communication with their HCP and more efficient visits. This type of document could be applied to the management of other conditions and as such have broader impact on the future of healthcare, which is currently immersed in far-reaching change and transformation.
ABSTRACT
BACKGROUND AND OBJECTIVE: Chronic rhinosinusitis with nasal polyps (CRSwNP), characterized by partial (hyposmia) or total (anosmia) loss of smell, is commonly associated with asthma and/or nonsteroidal anti-inflammatory drug-exacerbated respiratory disease (N-ERD), worsens disease severity and quality of life. Objectives. The objective of this study was to determine whether, in real-life conditions, biological treatments prescribed for severe asthma can improve olfaction in patients with CRSwNP. A further objective was to compare smell improvement in N-ERD and non-N-ERD subgroups. METHODS: A multicenter, non-interventional, retrospective, observational study was performed, including 206 patients with severe asthma undergoing biological treatment (omalizumab, mepolizumab, benralizumab, or reslizumab) with CRSwNP. RESULTS: Improved olfaction was found after treatment with all monoclonal antibodies: omalizumab (35.8%), mepolizumab (35.4%), reslizumab (35.7%), and benralizumab (39.1%), with no differences between groups. Patients with atopy, greater use of short course systemic corticosteroids, and larger polyp size were more likely to experience improvement in smell. The proportion of patients experiencing smell improvement was similar between the N-ERD (37%) and non-N-ERD (35.7%) groups. CONCLUSION: This is the first study to compare real-life improvement in sense of smell among patients undergoing long-term treatment with omalizumab, mepolizumab, reslizumab, or benralizumab for severe asthma and associated CRSwNP. Approximately 4 out of 10 patients reported a subjective improvement in sense of smell (with non-significant differences between biologic drugs). No differences were found in smell improvement between the N-ERD and non-N-ERD group.