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To assess the quality of treatment of patients with asthma who were treated jointly by pulmonologists and the family doctor, a data analysis was performed in 13 asthma specialists in 894 asthmatics and a written survey of patients after 3 months of treatment.The data analysis related to the current therapy, the therapy changes and the changes in asthma control test (ACT). One focus of the investigation was placed on the separate analysis of patients with controlled and uncontrolled asthma. Both patient groups show both decrease, as well as increases in the number of points of the ACT. In patients with non-controlled asthma, the proportion of an increase in the number of points in the ACT is above average and indicates an improvement of the disease. This is operated in the patient's subjective assessment. In both patient groups there is a large proportion of patients who report a subjective improvement. An improvement is usually achieved by an improved pharmacotherapy, a deterioration usually occurs due to external influences. The differences for the patient groups are here but less significantly. There is a general satisfaction with both the drug therapy, as well as with the handling. The inhalation drug therapy is performed very stable. In patients with poor asthma control therapy is usually intensified. In oral pharmacotherapy oral steroid therapy has a great dynamic in patients with uncontrolled asthma. In this group, the most frequent increases in the dose of inhaled substances are recorded., (© Georg Thieme Verlag KG Stuttgart · New York.)

In the present study, patients with asthma were interviewed with regard to their treatment adherence. It was shown that adherence is significantly influenced by age, occupation, quality of information about the disease and interest of the patient in disease, mode of action and use of the inhalation device. Younger, working patients who do not feel "completely adequately" informed are more likely to be not-adherent. Each aspect should be noted separately.The characterization enables forming target groups for appropriate counselling initiatives in pulmonology practice and allows the effectiveness of the measures to be examined. The results confirm the importance of doctor/patient communication for achieving a high level of adherence and thus therapeutic success.It is suggested that, in addition to questionnaires already in use, asthma patients should be given the following questions in writing during routine monitoring of therapy; based on the results of the survey, the extent of advice necessary can be determined -Do you feel sufficiently informed about your illness? -Do you feel sufficiently informed about the effect of the drug therapy? -Do you feel sufficiently informed about the handling of the inhalation drugs? -Are you satisfied with the handling of your inhalation medication? The following options to answer the questions should be available: completely - mainly - somewhat - not at all. There were significant differences in adherence between patients who were completely satisfied with the handling of their device and those that were not. However, there was no significant difference between the devices. Therefore, the same therapy adherence can be predicted for all devices when the device is suitable for the patient and also provides complete satisfaction in handling. Since it is the subjective perception of patients, the data show significant differences between study centres. These were mirrored in a blind benchmark to stimulate improvements., (© Georg Thieme Verlag KG Stuttgart · New York.)

Background: The efficacy and safety profile of ciclesonide (CIC) in the treatment of asthma was evaluated in a large patient population in a real-life setting in Germany., Methods: 24,037 patients with persistent mild/moderate bronchial asthma were enrolled into three observational studies with identical design. Data were pooled and analyzed. Patients received ciclesonide (160 μg/day) and were observed for 3 months. FEV(1), PEF, NO, asthma episodes, use of rescue medication and adverse drug reactions (ADR) were recorded., Results: Mean (95% CI) FEV(1) significantly increased from 80.7 [80.5; 80.9]% of predicted at baseline to 90.1 [89.9; 90.2]% after 3 months (n = 20,297), mean PEF significantly increased from 338 [335; 340] l/min to 392 [390; 395] l/min (n = 8100). NO was significantly reduced from 53.6 [51.8; 55.4] ppb to 26.2 [25.2; 27.1] ppb (n = 971). The percentage of patients with daily symptoms declined from 24.3% to 1.9%, night-time symptoms from 13.3% to 1.3%, and β(2)-agonists use from 26.9% to 8.8%. ADRs were reported by 51 patients (0.2%). Most frequent ADRs were: dysphonia (n = 11), cough (n = 10), dyspnoea, throat irritation, and oral candidiasis (n = 5 each). 46 patients terminated the study prematurely, 41 due to ADR and 5 due to unknown/missing reason. One patient died due to cardiac failure (no causal relation)., Conclusion: These observational studies under real-life conditions support findings from controlled clinical studies regarding efficacy and tolerability of ciclesonide in patients with mild to moderate bronchial asthma. No unexpected ADRs were detected., (Copyright © 2010 Elsevier Ltd. All rights reserved.)