Evaluation of an educational programme for socially deprived asthma patients

The aim of this study was to evaluate the effectiveness of an asthma education programme in moderate and severe asthma patients in a longitudinal, prospective and randomized study with a control group. Fifty-three asthmatic patients were studied, 26 of whom were assigned to the educational group and 27 to the control group.The educational group attended the programme regularly for a period of 6 months. the programme included information about asthma, instruction on the appropriate use of medication and training in the metered dose inhaler (MDI) technique, and information about the identification and control of asthma attacks and the recognition of early signs of exacerbation. the control group was submitted to the routine tare provided at the Asthma Clinic, with no formal instruction regarding asthma control. the groups were identical with regard to severity parameters, skills, lung function and quality of Life at the beginning of the trial.At the end of the study, the education group showed significant differences when compared with the control group education/control (mean values) with respect to: visits to the asthma emergency room over the previous 6 months, 0.7/2 (p=0.03); nocturnal symptoms, 0.3/0.7 (p=0.04); score of symptoms, 1.3/2 (p=0.04). Improvements were also observed in skills and quality of life, knowledge of how to deal with attacks and how to control the environmental triggering factors, 73/35 (<0.05); correct use of the MDI, 8/4 (0.001); understanding of the difference between relief and antiinflammatory medication, 86/20 (<0.05); and in the global limitation quality of life score, 28/50 (0.02).It is concluded that the educational programme led to a significant improvement in asthma morbidity and that the implantation of educational programmes is possible for special populations when these programmes are adapted to the socioeconomic profile of the patients, with a significant gain in terms of the reduction of symptoms and improved pulmonary function and quality of life of asthmatics.Universidade Federal de São Paulo, Dept Med, Lund Div, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Med, Lund Div, São Paulo, BrazilWeb of Scienc

LUNG INHALATION SCINTIGRAPHY - DEVELOPMENT of A NEW AEROSOL SYSTEM

ESCOLA PAULISTA MED,DISCIPLINA PNEUMOL,BR-04023 São Paulo,SP,BRAZILESCOLA PAULISTA MED,DISCIPLINA PNEUMOL,BR-04023 São Paulo,SP,BRAZILWeb of Scienc

Validation of a simplified socioeconomically quality-of-life questionnaire for deprived asthma patients

Introduction: Quality-of-life questionnaires have been recognized as an important tool to measure the impact of asthma in the patient's life and has become a main outcome in clinical research. To be effective, questionnaires should be adapted to reflect the needs of the target population. Objective: To assess the reliability, responsiveness, and cross-sectional validity of a simplified quality-of-life questionnaire (QQL-EPM) as a tool specially developed for a socioeconomically deprived target population of asthmatic patients. Method: Thirty-five asthma patients were followed in a prospective open study over a period of 9 weeks. Clinical visits were performed monthly with pulmonary function assessment and the patients filled out a diary card regarding symptom scores, use of rescue medication, and PEF. At each visit, FEV 1 and FVC were measured and two health-related quality-of-life questionnaires were applied: general quality of life (SF-36) and specific quality of life (QQL-EPM). the condition of patient regarding asthma control was assessed at each visit to the clinic, with treatment optimization and medication adjustment as needed. At the end of the study, each period was analyzed across the trial period and classified as stable or noncontrolled asthma. Results: QQL-EPM was able to correlate changes in quality of life in patients with alterations in their asthma control condition (global = 0.0001) and to differentiate these patients from those whose condition remained stable (global = 0.0001). the reliability of QQL-EPM was 0.68-0.90, and correlation with other clinical measurements and generic quality of life was moderate.Universidade Federal de São Paulo, Dept Med, Lung Div, EPM, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Med, Lung Div, EPM, São Paulo, BrazilWeb of Scienc

Validation of the mini pediatric asthma quality of life questionnaire and identification of risk factors affecting quality of life among Lebanese children

BACKGROUND: Few studies used various scales to assess the QOL in Lebanon in general but none was specific to asthma. Our objective was to assess the asthma-related quality of life, using the mini Pediatric Asthma Quality of Life Questionnaire (PAQLQ), in Lebanese asthmatic children, check its validity compared to the original version, and identify clinical and sociodemographic risk factors that might affect these children's QOL. METHODS: This retrospective study included 300 children aged between 7-16 years (51.6% boys and 48.4% girls). To confirm the mini-PAQLQ questionnaire construct validity in the Lebanese population, an exploratory factor analysis was launched for the 13 items of the questionnaire, using the principal component analysis technique. Cronbach's alpha was recorded for reliability analysis. A multivariate analysis linear regression was carried out, taking the QOL score as the dependent variable. RESULTS: The correlation coefficients for factors 1 (symptoms and emotions) and 2 (activities) were similar to that of the original scale. High Cronbach's alphas were found for factor 1 (0.914), factor 2 (0.888), and the full scale (0.921). Uncontrolled asthma, the child's respiratory problems before the age of 2 years, and the presence of pets at home significantly decreased the children's asthma-related quality of life (Beta = -1.541; Beta = -6.846, and Beta = -5.364, respectively). CONCLUSION: We were able to validate the mini-PAQLQ among the Lebanese population. The identification of risk factors, some of which are amenable to intervention, especially uncontrolled asthma, could lead to an improvement in the asthmatic children's QOL