title: A 1-day visit in a severe asthma centre: effect on asthma control, quality of life and healthcare use.
abstract: Patients with uncontrolled asthma report ongoing symptoms, poor quality-of-life and extensive healthcare use (HCU) and might benefit from management by a specialised severe asthma team. It is unknown whether a one-time evaluation by asthma experts, without long-term supervision by a specialised team, provides favourable outcomes. We evaluated asthma control (Asthma Control Questionnaire; ACQ), quality-of-life (Asthma-related Quality of Life Questionnaire; AQLQ) and HCU before and 1 year after a 1-day visit programme in a severe asthma centre, including a multidisciplinary assessment resulting in a personalised management plan to be implemented by patients own pulmonologists.40 uncontrolled asthma patients completed questionnaires (ACQ, AQLQ, HCU) at baseline, and 6 and 12 months follow-up.ACQ improved from 2.6 (interquartile range 1.7-3.2) to 1.8 (1.2-3.2) (p=0.003) and AQLQ from 4.8 (4.0-5.2) to 5.3 (4.4-6.0) (p<0.001). We found a reduction in patients with ≥2 exacerbations (95% versus 17%; p<0.001), ≥1 emergency room visit (78% versus 37%; p<0.001) and ≥1 hospitalisation (47% versus 10%; p=0.001).Evaluation of uncontrolled asthma patients in a 1-day visit programme in a severe asthma centre resulted in significant improvements in asthma control, quality-of-life and healthcare use after 1 year. This 1-day visit approach seems beneficial for uncontrolled asthma patients and might reduce their dependence on expensive treatment modalities and long-term management in specialised centres.
authors.affiliation: Dept of Respiratory Medicine, Medical Centre Leeuwarden, Leeuwarden, The Netherlands AkkeNynke.van.der.Meer@znb.nl.
authors.forename: Akke-Nynke
authors.initials: AN
authors.lastname: van der Meer
authors.affiliation: Dept of Respiratory Medicine, Medical Centre Leeuwarden, Leeuwarden, The Netherlands.
authors.forename: Henk
authors.initials: H
authors.lastname: Pasma
authors.affiliation: Dept of Respiratory Medicine, Medical Centre Leeuwarden, Leeuwarden, The Netherlands.
authors.forename: Wilma
authors.initials: W
authors.lastname: Kempenaar-Okkema
authors.affiliation: Dept of Medical Psychology, Medical Centre Leeuwarden, Leeuwarden, The Netherlands.
authors.forename: Jo-Anneke
authors.initials: JA
authors.lastname: Pelinck
authors.affiliation: Dept of Physiotherapy, Medical Centre Leeuwarden, Leeuwarden, The Netherlands.
authors.forename: Myrte
authors.initials: M
authors.lastname: Schutten
authors.affiliation: Dept of Clinical Chemistry, Medical Centre Leeuwarden, Leeuwarden, The Netherlands.
authors.forename: Huib
authors.initials: H
authors.lastname: Storm
authors.affiliation: Dept of Respiratory Medicine, Medical Centre Leeuwarden, Leeuwarden, The Netherlands.
authors.forename: Anneke
authors.initials: A
authors.lastname: Ten Brinke
mesh_terms: D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001249:Asthma / Q000523:psychology* / Q000628:therapy*; D003695:Delivery of Health Care; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D008875:Middle Aged; D015272:Pulmonary Medicine / Q000379:methods* / Q000458:organization & administration; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D018927:Anti-Asthmatic Agents