Search

Background: It was shown earlier that cold AHR worsens the course of asthma and decreases the quality of life (QL) in the cold season of the year. It is unknown how osmotic AHR influences QL in patients with asthma. Aim: To assess the influence of osmotic AHR on the health-related QL, emotional status and asthma control. Methods: 176 asthmatics were examined: 78 patients with osmotic AHR (1 st group) and 98 - without it (2 nd group). QL was assessed through questionnaires SF-36 and AQLQ, the emotional state - with the Hospital Anxiety and Depression Scale (HADS), asthma control - through ACT. Lung function was assessed by spirometry. Osmotic AHR was diagnosed at the fall of FEV 1 after 2-min ultrasound inhalation with distilled water by more than 10% from baseline. Results: Significant differences in all domains of SF-36 were found between 1 st and 2 nd groups. The most differences were registered in domains RF (50.7±4.4 vs. 74.5±3.4, p st group were found. According to AQLQ significant difference in domain “environment” (3.4±0.2 vs. 5.9±0.6, p st group (13.1±0.5 vs. 18.5±0.4 points ACT in 2 nd group, p Conclusion: Asthmatics with osmotic AHR have low level of general and specific QL, poor asthma control and unfavourable psychoemotional status.

Background. The adherence to treatment is very important to achieve asthma control. Group studying at asthma-school is one of the strategies to improve it. Aim . To define the efficiency of standard educational programs for asthma control achievement. Methods . 141 patients informed about their disease were examined. Mean age was 44±1.2 years old, mean duration of the disease was 6±0.8 years. The ACQ-5, Toronto Alexithymia Scale (TAS), developed questionnaire of assessment of adherence to treatment and the test “Awareness of patients about asthma” were used. Results. 27% of patients had controlled asthma. 24% of patients followed doctor9s recommendations. 107 non-adherence patients (76%) violated the regime of treatment and did not follow doctor9s prescription. These patients significantly differed by their low mean values of “compliancy index” (58.1±7.3 vs. 78.4±12.3%), high scores of TAS scale (66.2±2.3), low level of education and unemployment (14 vs. 3%). The degree of adherence negatively correlated with asthma severity (Spearman9s R=-0,68), asthma duration (R=-0.54) and TAS (R=-0.59). Before education 52% of patients had average knowledge and 48% had poor knowledge. After asthma-school 10% demonstrated high awareness, 44% had average awareness and 46% had poor knowledge. The level of obtained knowledge inversely depended on alexithymia (R=-0.89). 26-35 days later after ending of the course 39% of patients had a good asthma control. Meanwhile the control improved in 23% of cases and got worse in 5%. Conclusion . The number of patients with the controlled asthma after asthma-school increased from 27 till 39%. 46% patients did not learn the program, had rigidness and loss of control.

Background: Little is known about the influence of smoking on asthma clinical course, in particular, on health related quality of life (HRQL). Aim: To find out the influence of smoking on HRQL in asthmatics. Methods: 96 patients were divided into 3 groups: active smokers (n=29), ex-smokers (n=22) and non-smokers (n=46). HRQL was assessed by the questionnaires SF-36 and AQLQ, the level of anxiety and depression by HADS. The asthma control was defined by ACT. The lung function was studied with spirometry. Results: Smokers had a significantly lower levels in 4 out of 8 domens of SF-36 in comparison with non-smokers: Physical Functioning, General Health, Vitality and Social Functioning. The role of "Bodily Pain" in activity limitation was significantly higher (82.8±3.5 vs. 61.4±7.6, p 50 (r=-0.47, p Conclusions: Smoking is associated with the significant worsening of HRQL in asthmatics associated with the disturbance of distal airway patency, anxiety and depression. Smoking cessation is accompanied by improvement in HRQL and asthma control.

Background: Prediction of asthma control is a difficult task because many factors affect the control achievement. These include not least the lung function. To evaluate it along with the spirometry, the computer-aided tomography (CT) which allows to make a 3-dimensional quantitative analysis of lung inflation has been used recently (Il9in, A.V. et al. Eur Respir J 2014; 44: Suppl. 58, 5541). Aim: To develop the method to predict the achievement of asthma control using the indices of airway patency and lung inflation. Methods: Retrospective comparative analysis of the initial fucntional (spirometry and 3D CT-volumetry) indices was done among 64 asthmatics who achieved (group 1, n=15) and did not achieve (group 2, n=39) the asthma control after 6-month base therapy. Results: With the help of the discriminant analysis a significant difference in the indices between group 1 and 2 was found out: FEV 1 3.1±0.2 and 2.5±0.1 l, respectively (p 1 +0.1×RI. The limit value of the discriminant function (d) is 48.37. If d≥48,37 the controlled course of asthma is predicted after 6 months of the base therapy. The probability of the correct prediction is 96.9%. Conclusion: The developed method allows to predict achievement of asthma control after 6 months of the base therapy. The essential feature of this method is the application of RI which reflects expiratory/inspiratory inflation in the whole volume of lungs.

Background: Low adherence to the treatment is one of the main problems which hampers the achievement of asthma control. Aim: To study psychological characteristics of asthmatics, affecting adherence to treatment. Methods: 141 patients with mild (n=28), moderate (n=86) and severe asthma (n=27) were examined. The mean age was 44±1.2 years old, the mean duration of the disease was 6±0.8 years. The questionnaire of the assessment of adherence to treatment at asthma, Toronto Alexithymia Scale – TAS (G.Taylor, 1984), and self-questionnaire for identification of depression CES-D (M.M.Weissman et al., 1977) were used. Results: While self-filling questionnaire of the assessment of adherence to treatment the patients overestimated their compliance (self-assessment of compliance index was 100%). Therefore, we used the data from interviews with patients. The patients were divided into 2 groups according to adherence to treatment. The 1 st group included 34 patients with high adherence to treatment. The 2 nd group consisted of 107 patients who violated the regime of treatment and did not follow the prescriptions. The 2 nd group significantly differed from the 1 st one by low mean values of "compliancy index" (58.1±7.3 vs. 78.4±12.3%), high indices of TAS (66.2±2.3), low level of education and unemployment (14 vs. 3%). All patients had high safety needs (the mean index was 87.6±6.3%). The degree of adherence to treatment inversely correlated with asthma severity (Spearman9s R=-0,68), the duration of the disease (R=-0,54), the level of depression (R=-0.59). Conclusion: The severity and duration of asthma, alexithymia, poor education and unemployment have most influence on the degree of adherence to treatment in patients with asthma.