Asthma management in a specialist setting: Results of an Italian Respiratory Society survey.
Asthma considerably impairs patients' quality of life and increases healthcare costs. Severity, morbidity, and degree of disease control are the major drivers of its clinical and economic impact. National scientific societies are required to monitor the application of international guidelines and to adopt strategies to improve disease control and better allocate resources.



to provide a detailed picture of the characteristics of asthma patients and modalities of asthma management by specialists in Italy and to develop recommendations for the daily management of asthma in a specialist setting.



A quantitative research program was implemented. Data were collected using an ad hoc questionnaire developed by a group of specialists selected by the Italian Pneumology Society/Italian Respiratory Society.



The records of 557 patients were analyzed. In the next few years, specialists are expected to focus their activity patients with more severe disease and will be responsible for selection of patients for personalized biological therapy; however, only 20% of patients attending Italian specialist surgery can be considered severe. In 84.4% of cases, the visit was a follow-up visit requested in 82.2% of cases by the specialist him/herself. The Asthma Control Test is used only in 65% of patients. When available, a significant association has been observed between the test score and asthma control as judged by the physician, although concordance was only moderate (κ = 0.68). Asthma was considered uncontrolled by the specialist managing the case in 29.1% of patients; nevertheless, treatment was not stepped up in uncontrolled or partly controlled patients (modified in only 37.2% of patients).



The results of this survey support re-evaluation of asthma management by Italian specialists. More resources should be made available for the initial visit and for more severely ill patients. In addition, more extensive use should be made of validated tools, and available drugs should be used more appropriately.
Allergy & Respiratory Diseases, Department of Internal Medicine- University of Genoa, Italy. Electronic address: fulvio.braido@unige.it.
Fulvio
F
Braido
Allergy & Respiratory Diseases, Department of Internal Medicine- University of Genoa, Italy.
Ilaria
I
Baiardini
Servizio di Riabilitazione Respiratoria e prevenzione Tisiopneumologica USL, Perugia, Umbria 1, Italy.
Pietro
P
Alleri
Cardio-Thoracic and Vascular Department, University of Pisa, Italy.
Elena
E
Bacci
Section of Respiratory Diseases Department of Medical Sciences - University of Ferrara, Italy.
Carlo
C
Barbetta
Medical Science, University of Turin, Italy.
Michela
M
Bellocchia
Department of Internal Medicine, University of Palermo, Italy.
Alida
A
Benfante
Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Cardio-thoracic unit and Cystic Fibrosis Adult Center Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico Milano, Italy.
Francesco
F
Blasi
Medical Science, University of Turin, Italy.
Caterina
C
Bucca
Department of Medical and Surgical Sciences, Section of Respiratory Diseases, University "Magna Græcia" of Catanzaro, Italy.
Maria Teresa
MT
Busceti
Respiratory Unit, San Paolo Hospital, Department of Medical Sciences, University of Milan, Milan, Italy.
Stefano
S
Centanni
Malattie Apparato Respiratorio. Universitaria Azienda Ospedaliero-universitaria Ospedali Riuniti di Foggia, Italy.
Maria Cristina
MC
Colanardi
Section of Respiratory Diseases Department of Medical Sciences - University of Ferrara, Italy.
Marco
M
Contoli
Pneumology Unit, Department of Internal Medicine and Medical Therapy, San Matteo Polyclinic and Institute for Scientific Research, University of Pavia, Italy.
Angelo
A
Corsico
Unit of Pneumotisiology, Monaldi-AO Dei Colli Hospital, Federico II University, Naples, Italy.
Maria
M
D'Amato
Respiratory Unit, San Paolo Hospital, Department of Medical Sciences, University of Milan, Milan, Italy.
Fabiano
F
Di Marco
Servizio di Riabilitazione Respiratoria e prevenzione Tisiopneumologica USL, Perugia, Umbria 1, Italy.
Dottorini
D
Marco
Allergy & Respiratory Diseases, Department of Internal Medicine- University of Genoa, Italy.
Marta
M
Ferrari
Federico II University, Naples, Italy.
Giovanni
G
Florio
Department of Respiratory Diseases, Azienda Ospedaliero Universitaria di Sassari, Italy.
Alessandro Giuseppe
AG
Fois
Department of Medical and Surgical Sciences, University of Foggia, Italy.
Maria Pia
MP
Foschino Barbaro
Allergy & Respiratory Diseases, Department of Internal Medicine- University of Genoa, Italy.
Garuti
G
Silvia
Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Section of Respiratory Diseases, University of Messina, Policlinico Universitario "G.Martino", Messina, Italy.
Giuseppe
G
Girbino
Department of Internal Medicine and Medical Therapy, University of Pavia, Italy.
Amelia
A
Grosso
Cardio-Thoracic and Vascular Department, University of Pisa, Italy.
Manuela
M
Latorre
Pulmonology Department, Santa Corona Hospital, Pietra Ligure, Savona, Italy.
Sara
S
Maniscalco
Presidio Ospedaliero di Pordenone, Italy.
Francesco
F
Mazza
Pulmonology Department, Santa Corona Hospital, Pietra Ligure, Savona, Italy.
Carlo
C
Mereu
Department of Psychology, University of Turin, Italy.
Giorgia
G
Molinengo
Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
Josuel
J
Ora
Cardio-Thoracic and Vascular Department, University of Pisa, Italy.
Pierluigi
P
Paggiaro
Allergy and Clinical Immunology Division, Battipaglia Hospital, Department of Medicine ASL Salerno, Italy.
Vincenzo
V
Patella
Department of Medical and Surgical Sciences, Section of Respiratory Diseases, University "Magna Græcia" of Catanzaro, Italy.
Girolamo
G
Pelaia
Department of Respiratory Diseases, Azienda Ospedaliero Universitaria di Sassari, Italy.
Pietro
P
Pirina
Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Section of Respiratory Diseases, University of Messina, Policlinico Universitario "G.Martino", Messina, Italy.
Alfio
A
Proietto
Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
Paola
P
Rogliani
University of Milan, Respiratory Unit, L. Sacco Hospital, ASST Fatebenefratelli Sacco, Milano, Italy.
Pierachille
P
Santus
Department of Internal Medicine, University of Palermo, Italy.
Nicola
N
Scichilone
Federico II University, Naples, Italy.
Francesca
F
Simioli
Medical Science, University of Turin, Italy.
Paolo
P
Solidoro
Respiratory Unit, San Paolo Hospital, Department of Medical Sciences, University of Milan, Milan, Italy.
Silvia
S
Terraneo
Presidio Ospedaliero di Pordenone, Italy.
Umberto
U
Zuccon
Personalized Medicine Clinic: Asthma & Allergy - Humanitas Clinical and Research Center, Department of Biomedical Science, Humanitas University -Rozzano Milano, Italy.
Giorgio Walter
GW
Canonica
D000328:Adult; D000368:Aged; D001249:Asthma / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011788:Quality of Life; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013038:Specialization; D011795:Surveys and Questionnaires