Guarnieri Gabriella, Olivieri Bianca, Latorre Manuela, Rizzi Angela, Blasi Francesco, Canonica Giorgio Walter, Heffler Enrico, Paggiaro Pierluigi, Senna Gianenrico, Caminati Marco
Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy.
Medical Department, Allergy Unit and Asthma Center, Verona Integrated University Hospital, Verona, Italy.
Eur Clin Respir J. 2024 Aug 16;11(1):2381307. doi: 10.1080/20018525.2024.2381307. eCollection 2024.
Initiated by the Severe Asthma Network Italy (SANI), this study aims to explore asthma patients' perceptions of disease severity, differentiating between mild and severe asthma. The objective is to identify factors influencing tailored treatment strategies for varying disease severities and to provide insights into asthma care in Italy.
Conducted between November 2020 and January 2021, a survey using Computer-Assisted Personal Interviewing (CAPI) collected data from 308 Italian adults, representing the population. A 25 item multiple choice questionnaire covered asthma diagnosis, symptoms, treatment approaches, associated conditions, and quality of life.
Among participants, 83.8% reported having mild asthma, while 16.2% had severe asthma. Severe asthma patients had longer disease durations, more severe symptoms, frequent exacerbations, and higher hospital/ER visits. Although treatment adherence and symptom profiles generally aligned with international guidelines for self reported severe asthma, 22% of self identified mild asthmatics experienced severe respiratory symptoms. Oral corticosteroid (OCS) use was observed in 50% of severe cases and 22% of mild cases. Adherence was higher in severe asthma patients (76%) versus mild asthma patients (28%). Both groups experienced comorbidities, with 96% of severe asthmatics and 72% of mild asthmatics reporting impaired quality of life.
This study highlights the disparity between clinical categorization and patient perceptions of asthma severity. The prevalence of self reported severe asthma exceeds literature data. The burden of mild asthma remains significant, with treatment approaches not fully aligned, particularly regarding disproportionate OCS use. Addressing this gap requires enhancing patient education, improving diagnostic practices, and promoting adherence.
本研究由意大利重症哮喘网络（SANI）发起，旨在探讨哮喘患者对疾病严重程度的认知，区分轻度和重度哮喘。目的是确定影响针对不同疾病严重程度制定个性化治疗策略的因素，并为意大利的哮喘护理提供见解。
在2020年11月至2021年1月期间进行，采用计算机辅助个人访谈（CAPI）的调查从308名代表意大利成年人群体的数据中收集信息。一份包含25个项目的多项选择题问卷涵盖了哮喘诊断、症状、治疗方法、相关病症和生活质量。
在参与者中，83.8%报告患有轻度哮喘，而16.2%患有重度哮喘。重度哮喘患者的病程更长，症状更严重，频繁发作，住院/急诊就诊次数更多。尽管治疗依从性和症状特征总体上符合自我报告的重度哮喘的国际指南，但22%自我认定为轻度哮喘的患者出现了严重的呼吸道症状。50%的重度病例和22%的轻度病例使用了口服皮质类固醇（OCS）。重度哮喘患者的依从性（76%）高于轻度哮喘患者（28%）。两组均有合并症，96%的重度哮喘患者和72%的轻度哮喘患者报告生活质量受损。
本研究突出了哮喘严重程度的临床分类与患者认知之间的差异。自我报告的重度哮喘患病率超过了文献数据。轻度哮喘的负担仍然很大，治疗方法尚未完全一致，特别是在OCS使用不成比例方面。解决这一差距需要加强患者教育、改进诊断方法并提高依从性。
