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Vol 78, No 1 (2010)
ORIGINAL PAPERS
Published online: 2010-01-29
Submitted: 2013-02-22
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The underdiagnosis and undertreatment of asthma in general population of the Lodz Province (Poland)

Izabela Kupryś-Lipińska, Anna Elgalal, Piotr Kuna
Pneumonol Alergol Pol 2010;78(1):21-27.

open access

Vol 78, No 1 (2010)
ORIGINAL PAPERS
Published online: 2010-01-29
Submitted: 2013-02-22

Abstract


Introduction: Hundreds of studies investigating the epidemiology of asthma in various populations have been conducted in the past 30 years, yielding a large body of interesting data, including data on prevalence and risk factors. Less information is, however, available on the accurate diagnosis of asthma and its correct treatment. Epidemiological studies of the prevalence of asthma in the general population was conducted between 1998 and 2000 in the Lodz Province in Poland. The present analysis is an evaluation of the detectability and treatment of this disease.
Material and methods: The study group consisted of 1522 randomly selected residents of the Lodz Province aged 3 to 80 years. The demographics and medical history were collected using standardised questionnaires. All the respondents underwent skin prick tests and screening spirometry. Additional diagnostic tests were performed in doubtful cases.
Results: Complete data collected from 1340 subjects (1057 adults and 283 children) were included in the analysis. The prevalence of asthma was calculated at 7.3% in adults and 8.5% in children. The accurate diagnosis of asthma had not been made in 71% of symptomatic children and 49% of the adults. Forty-eight percent of adult asthmatics had not used any antiasthmatic medication in the previous 12 months. Subjects suffering from asthma had most commonly used the following drugs in the previous 12 months: β2-agonists (46.8%), anticholinergics (13%), inhalation glucocorticoids (36.4%), oral glucocorticoids (16.9%), parenteral glucocorticoids (3.9%), xanthine derivatives (33.8%) and cromones (11.7%).
Conclusions: The results of this study reveal shortcomings in the healthcare system which require appropriate actions aimed at early diagnosis and improvement of allergy treatment before the patient’s health deteriorates irreversibly.

Abstract


Introduction: Hundreds of studies investigating the epidemiology of asthma in various populations have been conducted in the past 30 years, yielding a large body of interesting data, including data on prevalence and risk factors. Less information is, however, available on the accurate diagnosis of asthma and its correct treatment. Epidemiological studies of the prevalence of asthma in the general population was conducted between 1998 and 2000 in the Lodz Province in Poland. The present analysis is an evaluation of the detectability and treatment of this disease.
Material and methods: The study group consisted of 1522 randomly selected residents of the Lodz Province aged 3 to 80 years. The demographics and medical history were collected using standardised questionnaires. All the respondents underwent skin prick tests and screening spirometry. Additional diagnostic tests were performed in doubtful cases.
Results: Complete data collected from 1340 subjects (1057 adults and 283 children) were included in the analysis. The prevalence of asthma was calculated at 7.3% in adults and 8.5% in children. The accurate diagnosis of asthma had not been made in 71% of symptomatic children and 49% of the adults. Forty-eight percent of adult asthmatics had not used any antiasthmatic medication in the previous 12 months. Subjects suffering from asthma had most commonly used the following drugs in the previous 12 months: β2-agonists (46.8%), anticholinergics (13%), inhalation glucocorticoids (36.4%), oral glucocorticoids (16.9%), parenteral glucocorticoids (3.9%), xanthine derivatives (33.8%) and cromones (11.7%).
Conclusions: The results of this study reveal shortcomings in the healthcare system which require appropriate actions aimed at early diagnosis and improvement of allergy treatment before the patient’s health deteriorates irreversibly.
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Keywords

epidemiology of asthma; asthma underdiagnosis; asthma undertreatment

About this article
Title

The underdiagnosis and undertreatment of asthma in general population of the Lodz Province (Poland)

Journal

Advances in Respiratory Medicine

Issue

Vol 78, No 1 (2010)

Pages

21-27

Published online

2010-01-29

Bibliographic record

Pneumonol Alergol Pol 2010;78(1):21-27.

Keywords

epidemiology of asthma
asthma underdiagnosis
asthma undertreatment

Authors

Izabela Kupryś-Lipińska
Anna Elgalal
Piotr Kuna

References (23)
  1. van Moerbeke D. European Allergy White Paper. Allergic diseases as a public health problem in Europe. The UCB Institute of Allergy, Brussels 1997.
  2. Bousquet J, Ansotegui IJ, van Ree R, et al. European Union meets the challenge of the growing importance of allergy and asthma in Europe. Allergy. 2004; 59(1): 1–4.
  3. Lis G, Breborowicz A, Cichocka-Jarosz E, et al. International Study of Asthma and Allergies in Childhood. [Increasing prevalence of asthma in school children--ISAAC study (International Study of Asthma and Allergies in Children)]. Pneumonol Alergol Pol. 2003; 71(7-8): 336–343.
  4. Stelmach W, Bobrowska M, Stelmach I. [Risk factors for asthma in children in Lódź region]. Pneumonol Alergol Pol. 2004; 72(5-6): 170–176.
  5. Stelmach W, Korzeniewska A, Krakowiak J, et al. [Retrospective analysis of the results of Allergic Diseases Prevention Program in children in the Lódź area]. Pneumonol Alergol Pol. 2004; 72(5-6): 192–197.
  6. van Schayck CP, van Der Heijden FM, van Den Boom G, et al. Underdiagnosis of asthma: is the doctor or the patient to blame? The DIMCA project. Thorax. 2000; 55(7): 562–565.
  7. Nish WA, Schwietz LA. Underdiagnosis of asthma in young adults presenting for USAF basic training. Ann Allergy. 1992; 69(3): 239–242.
  8. Ehrlich RI, Jordaan E, du Toit D, et al. Underrecognition and undertreatment of asthma in Cape Town primary school children. S Afr Med J. 1998; 88(8): 986–994.
  9. Enright PL, McClelland RL, Newman AB, et al. Underdiagnosis and undertreatment of asthma in the elderly. Cardiovascular Health Study Research Group. Chest. 1999; 116(3): 603–613.
  10. Bousquet J, Knani J, Henry C, et al. Undertreatment in a nonselected population of adult patients with asthma. J Allergy Clin Immunol. 1996; 98(3): 514–521.
  11. Małolepszy J, Liebhart J, Wojtyniak B, et al. Występowanie chorób alergicznych w Polsce. Alergia Astma Immunologia. 2000; 5(supl. 2): 163–169.
  12. Standardization of spirometry--1987 update. Statement of the American Thoracic Society. Am Rev Respir Dis. 1987; 136(5): 1285–1298.
  13. American Thoracic Society. Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease (COPD) and asthma. This official statement of the American Thoracic Society was adopted by the ATS Board of Directors, November 1986. Am Rev Respir Dis. 1987; 136(1): 225–244.
  14. Siersted HC, Boldsen J, Hansen HS, et al. Population based study of risk factors for underdiagnosis of asthma in adolescence: Odense schoolchild study   Commentary: Risk factors for underdiagnosis of asthma in adolescence   Commentary: Identifying the correct risks in diagnosis   Commentary: Improving the diagnostic rate in asthma: a community issue. BMJ. 1998; 316(7132): 651–657.
  15. Montnémery P, Hansson L, Lanke J, et al. Accuracy of a first diagnosis of asthma in primary health care. Fam Pract. 2002; 19(4): 365–368.
  16. Nathell L, Larsson K, Jensen I. Determinants of undiagnosed asthma. Allergy. 2002; 57(8): 687–693.
  17. Bauman A, Young L, Peat JK, et al. Asthma under-recognition and under-treatment in an Australian community. Aust N Z J Med. 1992; 22(1): 36–40.
  18. Hill RA, Standen PJ, Tattersfield AE. Asthma, wheezing, and school absence in primary schools. Arch Dis Child. 1989; 64(2): 246–251.
  19. Watari M, Ohe M, Komagata H, et al. [Emergency room visits by patients with exacerbations of asthma]. Nihon Kokyuki Gakkai Zasshi. 1998; 36(5): 438–443.
  20. Hartert TV, Windom HH, Peebles RS, et al. Inadequate outpatient medical therapy for patients with asthma admitted to two urban hospitals. Am J Med. 1996; 100(4): 386–394.
  21. Bousquet J, Hatton F, Godard P, et al. Asthma mortality in France. J Allergy Clin Immunol. 1987; 80(3 Pt 2): 389–394.
  22. Foucard T, Graff-Lonnevig V. Asthma mortality rate in Swedish children and young adults 1973?88. Allergy. 1994; 49(8): 616–619.
  23. Gessner BD, Neeno T. Trends in asthma prevalence, hospitalization risk, and inhaled corticosteroid use among alaska native and nonnative medicaid recipients younger than 20 years. Ann Allergy Asthma Immunol. 2005; 94(3): 372–379.

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