What pulmonologists think about the asthma-COPD overlap syndrome
Background: Some patients with COPD may share characteristics of asthma; this is the so-called asthma-COPD overlap syndrome (ACOS). There are no universally accepted criteria for ACOS, and most treatments for asthma and COPD have not been adequately tested in this population. Materials and methods:...
| Autores: | , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Tipo de recurso: | artículo |
| Fecha de publicación: | 2015 |
| País: | España |
| Institución: | Instituto de Salud Carlos III (ISCIII) |
| Repositorio: | Repisalud |
| Idioma: | inglés |
| OAI Identifier: | oai:repisalud.isciii.es:20.500.12105/20089 |
| Acceso en línea: | http://hdl.handle.net/20.500.12105/20089 |
| Access Level: | acceso abierto |
| Palabra clave: | Especialización Antiasmáticos Femenino Actitud del Personal de Salud Masculino Consenso Fumar Enfermedad Pulmonar Obstructiva Crónica Factores de Riesgo Broncodilatadores Humanos Persona de Mediana Edad Valor Predictivo de las Pruebas Conocimientos, Actitudes y Práctica en Salud Pronóstico Asma Encuestas y Cuestionarios Corticoesteroides Agonistas de Receptores Adrenérgicos beta 2 Neumología España Asthma Spain Pulmonary Medicine Adrenal Cortex Hormones Pulmonary Disease, Chronic Obstructive Humans Smoking Health Knowledge, Attitudes, Practice Bronchodilator Agents Middle Aged Prognosis Adrenergic beta-2 Receptor Agonists Male Predictive Value of Tests Anti-Asthmatic Agents Attitude of Health Personnel Female Risk Factors Consensus Specialization |
| Sumario: | Background: Some patients with COPD may share characteristics of asthma; this is the so-called asthma-COPD overlap syndrome (ACOS). There are no universally accepted criteria for ACOS, and most treatments for asthma and COPD have not been adequately tested in this population. Materials and methods: We performed a survey among pulmonology specialists in asthma and COPD aimed at collecting their opinions about ACOS and their attitudes in regard to some case scenarios of ACOS patients. The participants answered a structured questionnaire and attended a face-to-face meeting with the Metaplan methodology to discuss different aspects of ACOS. Results: A total of 26 pulmonologists with a mean age of 49.7 years participated in the survey (13 specialists in asthma and 13 in COPD). Among these, 84.6% recognized the existence of ACOS and stated that a mean of 12.6% of their patients might have this syndrome. In addition, 80.8% agreed that the diagnostic criteria for ACOS are not yet well defined. The most frequently mentioned characteristics of ACOS were a history of asthma (88.5%), significant smoking exposure (73.1%), and postbronchodilator forced expiratory volume in 1 second/forced vital capacity,0.7 (69.2%). The most accepted diagnostic criteria were eosinophilia in sputum (80.8%), a very positive bronchodilator test (69.2%), and a history of asthma before 40 years of age (65.4%). Up to 96.2% agreed that first-line treatment for ACOS was the combination of a long-acting beta(2)-agonist and inhaled steroid, with a long-acting antimuscarinic agent (triple therapy) for severe ACOS. Conclusion: Most Spanish specialists in asthma and COPD agree that ACOS exists, but the diagnostic criteria are not yet well defined. A previous history of asthma, smoking, and not fully reversible airflow limitation are considered the main characteristics of ACOS, with the most accepted first-line treatment being long-acting beta(2)-agonist/inhaled corticosteroids. |
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