ASTHMA WATCH

Patients Do Not Believe Disease Is Chronic

If inner-city adults with asthma do not see their conditionas chronic, researchers are worried that this perceptionwill interfere with asthma management. A study,reported in Chest (March 2006), surveyed 198 adults whowere hospitalized with asthma at an inner-city hospitalover a 12-month period. The patients were asked to gaugetheir perceptions about their disease, medication use, andother health issues. The investigators noted that the participantswere largely low-income and non-Caucasianindividuals who had to go to the emergency room for asthmaor be admitted to the hospital.

The study found that 53% of the patients believed thatwhen they did not exhibit symptoms they did not have asthma.Men and older patients were most likely to have this "nosymptoms, no asthma"perception. Also, these patients oftenexpected to be cured. Patients who believed that the diseasewas not chronic were 33% less likely to follow inhaledsteroid treatment when they were symptom-free.

Pharmacists Launch Asthma Program

The National Community Pharmacists Association, Medical Care and Outcomes LLC,and GlaxoSmithKline recently launched the Asthma Intervention Program. The nationwidepilot program will examine the vital role pharmacists can play in identifyingpatients with uncontrolled asthma and helping them by means of medication therapymanagement. The pilot will be limited to 500 pharmacies nationwide.

The program will use the Asthma Control Test, a 5-question assessment tool recommendedby the American Lung Association, to evaluate how well a patient's asthma currentlyis being controlled. A series of interventions, as well as communications with thepatient's physician for 6 months, will assess the impact pharmacists can have in deliveringpatient care services and improving health outcomes.

For the study, each participating pharmacy will be required to enroll at least 15patients. Patient data will be entered electronically into a Health Insurance Portabilityand Accountability Act-compliant database developed by Medical Care and Outcomes,which is available on-line through Pharmacist e-Link. For more information, visitwww.pharmacistelink.com/asthma.

Study Finds Leptin Correlation with Asthma

Evidence linking leptin levels with asthmain children prompted researchers todetermine whether the result was true foradults. Data from 5876 participants in theThird National Health and NutritionExamination Survey found that high levelsof leptin correlated with physician-diagnosedasthma in adults.

The researchers found, however, thatthe association was stronger in womenthan in men and stronger in premenopausalwomen, compared withpostmenopausal women.

As in earlier reports, body mass indexwas directly related to asthma risk. Takingleptin levels into account had very littleeffect on this association, according to thereport in Thorax (April 2006).

The researchers are planning to investigatethe roles of other fat-produced compoundsin the development of asthma. Afocus will be on adiponectin, an antiinflammatoryprotein that may offset theeffects of leptin.

Asthma Still Is Poorly Controlled

Despite many treatment options for asthma, new findings suggest that patientshave experienced emergency department visits, hospitalizations, or attacks at a ratethat has not declined significantly over time.

For the study, the researchers reviewed 3998 case records in an administrativeclaims database of a managed care setting. The patients included had an asthmadiagnosis and >2 claims per year for asthma medications over 4 years. The results ofthe study showed that over 4 years the exacerbation rate did not drop much.

The data indicated that 41% of patients had at least one asthma exacerbation. Of thesepatients, 30% were not taking daily asthma maintenance medication before the exacerbation.In addition, patients who had an exacerbation in the first year of the study wereabout 2 times as likely to experience another exacerbation at some point in the remainderof the study, compared with patients who were exacerbation-free in the first year.

Patients Want Better Allergy Medications

An Asthma and Allergy Foundationof America survey found that 31% ofpatients with allergies are not happywith their current prescription allergymedication. Of 1214 respondents,60% also said that they were interestedin finding a new prescriptionallergy medication.

Among the patients with allergieswho are not fully satisfied with theircurrent prescription medicine, 55%reported that they are not pleasedbecause their allergy medication doesnot relieve their symptoms longenough. Nearly 44% are not satisfiedbecause their medication does notprovide symptom relief fast enough.

In addition, the survey revealed that47% of patients with allergies takemultiple allergy prescription medications,and 36% of the participants whotake prescription allergy medicationalso reported using OTC allergy medication.The participants identified 3important aspects of allergy prescriptionmedication: that it be (1) long-lasting,(2) fast-acting, and (3) steroid-free.