Effects of short- and long-acting beta-agonists on asthma exacerbations : a prospective cohort

Funding Sources: The study was funded by the European Commission through the Seventh Framework Program (FP7-Grant Agreement n° 282 593) and gathered 7 partners in a consortium: Claude Bernard Lyon 1 University, University of Nottingham, Kappa Santé SAS, IMS Health, University of Amsterdam, Consortio Mar Parc de Salut de Barcelona and Lyon Ingénierie Projets. The study has been registered in the European Network of Centres for Pharmacoepidemiology and Pharmacovigilance (ENCePP) Registry under reference number ENCEPP/SDPP/3099.Peer reviewedPostprin

Mapping the Asthma Care Process : Implications for Research and Practice

The authors would like to thank the participants to the Respiratory Effectiveness Group Adherence symposium for their comments on the model overview presented during this meeting, members of the ASTRO-LAB consortium for collaborative work on reviewing literature and performing qualitative interviews, and patients and clinicians that shared valuable insights into asthma management during the telephone interviews. The research leading to these results has received funding from the European Community's 7th Framework (FP7/2007-2013) under grant agreement no. 282593.Peer reviewedPublisher PD

Explaining the amount and consistency of medical care and self-management support in asthma : a survey of primary care providers in France and the United Kingdom

Copyright © 2018. Published by Elsevier Inc.Peer reviewedPostprin

Asthma inhaler adherence determinants in adults : systematic review of observational data

Copyright ©ERS 2014. Acknowledgements We would like to thank Eric van Ganse (Claude Bernard University Lyon 1, Lyon, France) and Marcel Bouvy (Utrecht University, Utrecht, the Netherlands) for valuable discussions regarding the systematic review process, and Dan Dediu (Max Plank Institute, Nijmegen, the Netherlands) for support with conducting the review and summarising results visuallyPeer reviewedPostprin

Does adherence to inhaled corticosteroids predict asthma-related outcomes over time? A cohort study

Funding: The research leading to these results has received funding from the European Community 7th Framework (FP7/2007-2013) under grant agreement n°282593, and H2020 programme (MSCA-IF) under GA n°706028 for AD during manuscript preparation.Peer reviewedPostprin

Measuring medication adherence in asthma : Development of a novel self-report tool

Funding: This work was supported by European Community’s 7th Framework (FP7/2007-2013); Seventh Framework Programme [HEALTH-F5-2011-282593].Peer reviewedPublisher PD

Assessment of the safety of long-acting β2-agonists in routine asthma care: the ASTRO-LAB protocol.

ASTRO-LAB is funded by the European Commission through the Seventh Framework Program (FP7-Grant Agreement n° 282 593) and gathers seven partners in a Consortium: Université Claude Bernard Lyon 1, University of Nottingham, Kappa Santé SAS, Cegedim Strategic Data Medical Research Limited, University of Amsterdam, Consortio Mar Parc de Salut de Barcelona and Lyon Ingénierie Projets

Long-acting beta-agonists plus inhaled corticosteroids safety: a systematic review and meta-analysis of non-randomized studies

Background: Although several systematic reviews investigated the safety of long-acting beta–agonists (LABAs) in asthma, they mainly addressed randomized clinical trials while evidence from non-randomized studies has been mostly neglected. We aim to assess the risk of serious adverse events in adults and children with asthma treated with LABAs and Inhaled Corticosteroids (ICs), compared to patients treated only with ICs, from published non-randomized studies. Methods: The protocol registration number was CRD42012003387 (http://www.crd.york.ac.uk/Prospero webcite). Literature search for articles published since 1990 was performed in MEDLINE and EMBASE. Two authors selected studies independently for inclusion and extracted the data. A third reviewer resolved discrepancies. To assess the risk of serious adverse events, meta-analyses were performed calculating odds ratio summary estimators using random effect models when heterogeneity was found, and fixed effect models otherwise. Results: Of 4,415 candidate articles, 1,759 abstracts were reviewed and 220 articles were fully read. Finally, 19 studies met the inclusion criteria. Most of them were retrospective observational cohorts. Sample sizes varied from 50 to 514,216. The meta-analyses performed (69,939-624,303 participants according to the outcome considered) showed that odds ratio of the LABAs and ICs combined treatment when compared with ICs alone was: 0.88 (95% CI 0.69-1.12) for asthma-related hospitalization; 0.75 (95% CI 0.66-0.84) for asthma-related emergency visits; 1.02 (95% CI 0.94-1.10) for systemic corticosteroids; and 0.95 (95% CI 0.9-1.0) for the combined outcome. Conclusions: Evidence from observational studies shows that the combined treatment of LABAs and ICs is not associated with a higher risk of serious adverse events, compared to ICs alone. Major gaps identified were prospective design, paediatric population and inclusion of mortality as a primary outcome.Financial support for this study was provided by the Health Research Fund (European Union FP7, ASTROLAB project EC HEALTH-F5-2011-282593); the Agency for Management of University and Research Grants AGAUR (2012FI_B1 00177); and a Fundación Carolina Fellowship

Impact of asthma on women and men: comparison with the general population using the EQ-5D-5L questionnaire

Background: The aim was to evaluate the impact of asthma on patients’ Health-Related Quality of Life (HRQoL) by comparing asthmatic women and men with reference norms, to examine the factors which contributed to an impaired HRQoL, and to identify groups at higher risk. Methods: Cross-sectional evaluation of 222 primary care patients with persistent asthma (18–40 years old). HRQoL impact was estimated with the EuroQol-5 Dimensions (EQ-5D), which allows calculating Quality-Adjusted Life-Years (QALYs) by applying society preferences. Participants self-completed the EQ-5D questionnaire online. Telephonic interviews collected information on medication and adherence, and administered the Asthma Control Questionnaire. Severity markers included asthma-related comorbidity, previous oral corticosteroids course prescription, and inhaled corticosteroids daily dose. After bivariate analyses, multiple linear regression models were constructed to examine the relations between HRQoL asthma impact and socio-demographic and clinical variables, using as dependent variable the deviation from general population-based EQ-5D reference norms. Results: Deviation from the EQ-5D index norms was moderate in most age/gender groups (-0.1, which corresponds to 0.6 standard deviations), while it was large in women aged 18–24 years (-0.18, corresponding to 1.1 standard deviations). In regression models, a poor asthma control was the only factor independently associated to HRQoL impact in both women and men: β -0.18 (p<0.001) and -0.15 (p = 0.01) respectively. Translating these β coefficients to QALYs, they are interpretable as 66 fewer days of full health per year in women with uncontrolled asthma and 55 for men, compared with those with controlled asthma. Conclusion: Persistent asthma has a moderately negative HRQoL impact on patients of both genders, and the youngest women have been identified as a high risk group which merits further research. We identified asthma control as the major contributor to impaired HRQoL in patients, regardless of their gender, suggesting that asthma HRQoL impact could be alleviated by achieving a good control of symptoms