Prevalence of asthma control among adults in France, Germany, Italy, Spain and the UK.

The objectives of this article were to estimate the prevalence of asthma control and describe the characteristics of at least well-controlled (ALWC) versus not well-controlled (NWC) asthmatics. Data were obtained from the European National Health and Wellness Survey, an internet-based, cross-sectional study of 37,476 adults in France, Germany, Italy, Spain and the UK. Analysis was limited to 2,337 respondents who self-reported a physician diagnosis. Based on the Asthma Control Test (ACT), respondents were grouped as ALWC (ACT ≥20) and NWC (ACT ≤19). The prevalence of diagnosed asthma across five countries was estimated to be 5.8% (14 million extrapolated for the European Union population). Of these, 50.4% (7.1 million) were NWC. Compared with ALWC, NWC were older (15.8 versus 15.0%; p<0.001), less likely to be college educated (28.7 versus 36.3%; p<0.001) and more likely to be obese (30.0 versus 22.7%; p<0.001), experience depression (28.0 versus 18.7%; p<0.001) and smoke (34.7 versus 25.0%; p<0.001). The NWC had more occasions of contact with healthcare providers and were more likely to use controller and rescue medications, but with less adherence. A substantial portion of asthmatics are NWC. However, the proportion of NWC asthmatics found in this study was less than in previously reported. Patients and physicians need to be educated on the importance of asthma control and adherence to treatments.

Relationship between symptom load of gastro-oesophageal reflux disease and health-related quality of life, work productivity, resource utilization and concomitant diseases: survey of a US cohort.

BACKGROUND: Analysis of the burden of gastro-oesophageal reflux disease (GERD) in relation to the severity and frequency of symptoms is essential to identify individuals and groups in whom targeted management is justified. AIM: To describe the relationship between symptoms of GERD and self-reported health-related quality of life (HRQL), work productivity, healthcare utilization and concomitant diseases. METHODS: US respondents to the Internet-based 2004 National Health and Wellness Survey who had self-reported GERD (n = 10,028, mean age: 52 years, 58% female) were age- and gender-matched to a control group without GERD (n = 10,028). Respondents with GERD were classified according to symptom severity and frequency. HRQL and productivity were assessed using the Short-Form 8 survey (SF-8) and Work Productivity and Activity Impairment questionnaire, respectively. RESULTS: Symptom frequency increased with increasing symptom severity. Compared with controls, respondents with GERD had more concomitant diseases [mean difference (MD): 1.6], lower SF-8 physical and mental health scores (MD: 4.1 units and 3.1 units, respectively), increased absenteeism (MD: 0.9 h/week), reduced percent productivity at work (MD: 7.5%) and increased healthcare utilization. All tested variables deteriorated with increasing symptom severity and/or frequency. CONCLUSIONS: Increasing severity and frequency of GERD symptoms is associated with more concomitant diseases, lower HRQL, lower work productivity and increased healthcare utilization, suggesting that patients with moderate or severe GERD should receive targeted management with the most effective treatment strategies.