A apresentação está carregando. Por favor, espere

A apresentação está carregando. Por favor, espere

PACIENTES COM ASMA GRAVE E COM RINITE ASSOCIADA GERAM MAIORES CUSTOS PARA A FAM Í LIA E PARA O SISTEMA DE SAUDE EDUARDO V PONTE ROSANA FRANCO HARRISSON.

Apresentações semelhantes


Apresentação em tema: "PACIENTES COM ASMA GRAVE E COM RINITE ASSOCIADA GERAM MAIORES CUSTOS PARA A FAM Í LIA E PARA O SISTEMA DE SAUDE EDUARDO V PONTE ROSANA FRANCO HARRISSON."— Transcrição da apresentação:

1 PACIENTES COM ASMA GRAVE E COM RINITE ASSOCIADA GERAM MAIORES CUSTOS PARA A FAM Í LIA E PARA O SISTEMA DE SAUDE EDUARDO V PONTE ROSANA FRANCO HARRISSON FLORIAN ADELMIR SOUZA-MACHAD MAURICIO L BARRET CHARLES K NASPIT ALVARO A CRUZ Programa de Controle da Asma e da Rinite Alergica da Bahia Universidade Federal da Bahia

2 Evidences Rhinitis is a risk factor for severe asthma –Emergency room visit for acute asthma –Hospital admission for acute asthma –Asthma related quality of life –Cost of asthma

3 Objetivo Avaliar se o custo da asma e maior em pacientes asmáticos com rinite em comparação com pacientes sem rinite Avaliar se a gravidade dos sintomas de rinite estão associados a maior custo da asma

4 Patients Asthmatic patients at admission in ProAR Inclusion criteria Severe asthma > 12 years old ARIA criteria Exclusion criteria Abnormal chest x-ray Other pulmonary co-morbidities Severe extra-pulmonary disease

5 Study design 3 m V1V1 V2V2 V3V3 V4V4 V5V5 Last study visit V 1 : report of emergency room visit in the last year, provision of free topical medication and lung function V 2 : report of emergency room visit, cost data and provision of free topical medication V 3 : report of emergency room visit, cost data, provision of free topical medication and lung function V 4 : report of emergency room visit, cost data and provision of free topical medication V 5 : report of emergency room visit, cost data and provision of free topical medication and lung function Last study visit: rhinitis evaluation, ACQ, AQLQ, lung function and clinical evaluation of asthma control

6 Economic data Data from Patients were evaluated in order to estimate the direct and indirect cost of rhinitis and asthma for the public health system and for their families

7

8

9 U$

10

11 Cost of asthma according to severity of rhinitis No rhinitis (n=21) Mild rhinitis (n=84) Moderate/severe rhinitis (n=50) P Cost for the family6 (1-15)6 (3-13)9 (4-26)>0.05 Cost for the health care system398 ( )472 ( )559 ( )<0.01 Annual cost of asthma398 ( )478 ( )568 ( )<0.01

12 Conclusion Preliminary data indicate that the cost of asthma is increased in rhinitis patients, and correlate with the severity of rhinitis

13 Rhinitis and the risk of emergency room visit for acute asthma OR Bousquet J ( ) Bousquet J, Allergy 2005

14 Rhinitis and the risk of hospital admission for acute asthma OR Kocevar V 20041,72 (1,34-2,21) Price D 20051,52 (1,03-2,24) Thomas M 20052,34 (1,41-3,91)

15 Increased asthma severity and reduced response to treatment in patients with concomitant moderate to severe rhinitis OR (CI) Over 90% reduction in emergency room visits no rhinitis mild rhinitis moderate to severe rhinitis ( ) 0.27 ( ) Increased asthma severity in patients with concomitant moderate/severe rhinitis

16 Increased asthma severity and reduced response to treatment in patients with concomitant moderate to severe rhinitis OR (CI) Less than 10% improvement in FEV 1 no rhinitis mild rhinitis moderate to severe rhinitis ( ) 2.94 ( ) Increased asthma severity in patients with concomitant moderate/severe rhinitis

17 Quality of life and symptoms score in asthmatic patients with rhinitis No rhinitis (n = 77) Mild rhinitis (n = 262) Moderate/ severe rhinitis (n = 166) P ACQ score < 0.01 AQLQ score < 0.01

18 AQLQ scorep Rhinitis No rhinitis > 0.05 Sinusitis No sinusitis < 0.05 Rhinitis and asthma related quality of life Dixon AE, Chest 2006

19 The annual cost of asthma in USA AsthmaAsthma + rhinitis US$ 249US$ 335 Yawn BP, JACI 1999

20 Increased asthma severity and reduced response to treatment in patients with concomitant moderate to severe rhinitis OR (CI) Uncontrolled asthma no rhinitis mild rhinitis moderate to severe rhinitis ( ) ( ) Increased asthma severity in patients with concomitant moderate/severe rhinitis

21 The annual cost of asthma in Germany AsthmaAsthma + rhinitis 2,745 9,286 Schramm B, ERJ 2002

22 Rhinitis evaluation - last study visit ARIA criteria – Mild – Moderate/severe Questionnaire

23 ACQ questionnaire AQLQ questionnaire Clinical evaluation of symptoms control Diagnosis of refractory asthma Lung function test Asthma evaluation - last study visit

24 Characteristics of asthmatic patients enrolled in the study (n=557) Female gender (%)438 (78) Age (years)49 (38-59) Comorbidity (%)146 (46) Alliterated patients (%)60 (14) Smoking history > 10 pack years (%)68 (12) Rhinitis diagnosis (%) no rhinitis mild moderate to severe 82 (15) 299 (54) 176 (31)

25 Inhaled corticosteroid for asthma > 800 mcg/day (%)470 (84) Any Emergency room visit in the year of follow up (%)265 (47) Uncontrolled asthma (%)67 (20) FEV 1 pre-bronchodilator at last study visit68 (54-82) FVC pre-bronchodilator at last study visit91 (81-102) Characteristics of asthmatic patients enrolled in the study (n=557)


Carregar ppt "PACIENTES COM ASMA GRAVE E COM RINITE ASSOCIADA GERAM MAIORES CUSTOS PARA A FAM Í LIA E PARA O SISTEMA DE SAUDE EDUARDO V PONTE ROSANA FRANCO HARRISSON."

Apresentações semelhantes


Anúncios Google