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.