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Perception of Dyspnea and Treatment Adherence in Asthmatic Patients
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"referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] 2 => array:3 [ "nombre" => "Javier" "apellidos" => "Fullana" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 3 => array:3 [ "nombre" => "Vicente" "apellidos" => "Macián" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] 4 => array:3 [ "nombre" => "Amparo" "apellidos" => "Lloris" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] 5 => array:3 [ "nombre" => "Amparo" "apellidos" => "Belloch" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Servicio de Neumología, Hospital de Sagunto, Sagunto, Valencia, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Servicio de Neumología, Hospital Universitario La Fe, Valencia, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] 2 => array:3 [ "entidad" => "Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Facultad de Psicología, Universidad de Valencia, Valencia, Spain" "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dr E. Martínez-Moragón Avda. Pérez Galdós, 12-10 46007 Valencia, Spain" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2007-06-27" "fechaAceptado" => "2008-02-26" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec155385" "palabras" => array:4 [ 0 => "Dyspnea" 1 => "Asthma" 2 => "Perception" 3 => "Treatment adherence" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec155386" "palabras" => array:4 [ 0 => "Disnea" 1 => "Asma" 2 => "Percepción" 3 => "Cumplimiento terapéutico" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">The majority of studies show that treatment adherence in chronic diseases such as asthma does not exceed 50%. Although the reasons may vary, it is clear that lack of treatment adherence is a determining factor in poor disease control. An association has also been observed between lack of perception of dyspnea and difficult-to-control asthma and with the occurrence of fatal or near-fatal asthma attacks. In this study we therefore attempted to demonstrate that one of the reasons that asthmatic patients do not adhere to treatment is a failure to perceive dyspnea associated with bronchial obstruction.</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">We analyzed 2 groups of patients with moderate persistent asthma who had all been prescribed the same chronic treatment (a dose of inhaled drug administered with a dry powder inhaler every 12 hours). The first group comprised 24 patients (16 women and 8 men; mean [SD] age, 44 [15] years) who took the medication almost every day. The second group contained 24 patients (16 women and 8 men; mean [SD] age, 48 [14] years) who did not use the medication or only took it occasionally. There were no significant differences between the groups in terms of age, sex, percentage of smokers, socioeconomic and educational level, anxiety, depression, or spirometry variables. A histamine challenge test was carried out in all patients and the dyspnea perceived after each dose of the drug was measured on a modified Borg scale. The dose of histamine leading to a 20% reduction in forced expiratory volume in 1 second (FEV<span class="elsevierStyleInf">1</span>), perception of dyspnea associated with a 20% reduction in FEV<span class="elsevierStyleInf">1</span> (PS<span class="elsevierStyleInf">20</span>), and the change in dyspnea measured on the Borg scale between baseline and 20% reduction in FEV<span class="elsevierStyleInf">1</span> were analyzed. Patients were also classified as poor perceivers of dyspnea if the change in perception of dyspnea on the modified Borg scale was less than or equal to zero.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">The group of patients with poor treatment compliance had a lower PS<span class="elsevierStyleInf">20</span> (2.27 [1.9] vs 3.51 [1.8], <span class="elsevierStyleItalic">P</span>=.03) and change in Borg score (1.64 [1.9] vs 2.7 [1.84], <span class="elsevierStyleItalic">P</span>=.057), and they were more often poor perceivers of dyspnea (50% vs 21%, <span class="elsevierStyleItalic">P</span>=.034).</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">There is a relationship between treatment adherence and dyspnea perception, such that poor perception is among the reasons for poor treatment adherence in patients with asthma.</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">El cumplimiento terapéutico en una enfermedad crónica como el asma no supera el 50% en la mayoría de las series. Aunque las razones sean de muy diversa índole, es evidente que el incumplimiento es un factor determinante en el mal control de la enfermedad. Por otra parte, la falta de percepción de la disnea se ha asociado con el asma de control difícil y con la aparición de crisis de asma fatal o casi fatal. Así pues, el objetivo del presente estudio ha sido intentar demostrar que una de las razones por las cuales los asmáticos no toman su medicación es que no tienen percepción de disnea cuando sus bronquios se obstruyen.</p> <span class="elsevierStyleSectionTitle">Pacientes y métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Hemos estudiado a 2 grupos de pacientes con asma persistente y moderada, a quienes se había prescrito el mismo tratamiento de forma continuada (una dosis de medicación inhalada en polvo seco cada 12 h). El primero estaba formado por 24 pacientes (16 mujeres y 8 varones; edad media ± desviación estándar: 44 ± 15 años) que tomaban casi todos los días la medicación, y el segundo, por otros 24 pacientes (16 mujeres y 8 varones; edad media: 48 ± 14 años) que no tomaban la medicación o lo hacían sólo de vez en cuando. No había diferencias significativas entre los grupos en cuanto a edad, sexo, porcentaje de fumadores, niveles económico y educativo, ansiedad, depresión y parámetros espirométricos. A to-dos ellos se les realizó una prueba de broncoprovocación con histamina, y se midió la disnea experimentada tras cada dosis del fármaco en una escala modificada de Borg. Se determinaron la dosis de histamina con la que se alcanzó una caída del 20% en el volumen espiratorio forzado en el primer segundo (FEV<span class="elsevierStyleInf">1</span>), la percepción de disnea con una caída del FEV<span class="elsevierStyleInf">1</span> del 20% (PS<span class="elsevierStyleInf">20</span>) y el cambio de disnea en la escala de Borg desde la situación inicial hasta la caída del 20% de FEV<span class="elsevierStyleInf">1</span> (cambio en Borg). Además, se clasificó a los pacientes como hipoperceptores de disnea cuando su cambio en Borg fue igual o inferior a 0.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">El grupo de incumplidores tenía menor PS<span class="elsevierStyleInf">20</span> (2,27 ± 1,9 frente a 3,51 ± 1,8 en el grupo de cumplidores; p = 0,030) y cambio en Borg (1,64 ± 1,9 frente a 2,7 ± 1,84; p = 0,057), y eran con mayor frecuencia hipoperceptores de disnea (el 50% frente al 21%; p = 0,034).</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">Existe relación entre el cumplimiento del tratamiento y la percepción de disnea, de forma que uno de los motivos del incumplimiento terapéutico en los pacientes con asma es la hipopercepción de disnea.</p>" ] ] "NotaPie" => array:1 [ 0 => array:1 [ "nota" => "<p class="elsevierStyleNotepara">This study was partially funded by grant RTIC-03/11 from the Breathe Network (Red RESPIRA) of the Carlos III Health Institute.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:27 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical management of asthma in 1999; the Asthma Insights and Reality in Europe (AIRE) study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "KF Rabe" 1 => "PA Vermiere" 2 => "JB Soriano" 3 => "WC Maier" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Eur Respir J" "fecha" => "2000" "volumen" => "16" "paginaInicial" => "802" "paginaFinal" => "807" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11153575" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A comparison of primary care physicians and pneumologist in the management of asthma in Spain: ASES study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A López Viña" 1 => "JE Cimas" 2 => "C Díaz Sánchez" 3 => "G Coria" 4 => "O Vegazo" 5 => "C Picado" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Respir Med" "fecha" => "2003" "volumen" => "97" "paginaInicial" => "872" "paginaFinal" => "881" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12924513" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Predictors of poor asthma control in European adults" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "JB Soriano" 1 => "KF Rabe" 2 => "PA Vermiere" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Asthma" "fecha" => "2003" "volumen" => "40" "paginaInicial" => "803" "paginaFinal" => "813" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14626337" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nonadherence in asthmatic patients: is there a solution to the problem?" 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 3 | 4 | 7 |
| 2024 October | 29 | 15 | 44 |
| 2024 September | 27 | 11 | 38 |
| 2024 August | 46 | 29 | 75 |
| 2024 July | 27 | 19 | 46 |
| 2024 June | 48 | 31 | 79 |
| 2024 May | 47 | 40 | 87 |
| 2024 April | 14 | 22 | 36 |
| 2024 March | 20 | 17 | 37 |
| 2024 February | 17 | 20 | 37 |
| 2023 March | 3 | 3 | 6 |
| 2023 February | 15 | 19 | 34 |
| 2023 January | 19 | 35 | 54 |
| 2022 December | 18 | 38 | 56 |
| 2022 November | 17 | 28 | 45 |
| 2022 October | 21 | 34 | 55 |
| 2022 September | 15 | 29 | 44 |
| 2022 August | 19 | 34 | 53 |
| 2022 July | 17 | 39 | 56 |
| 2022 June | 17 | 31 | 48 |
| 2022 May | 18 | 35 | 53 |
| 2022 April | 14 | 20 | 34 |
| 2022 March | 15 | 34 | 49 |
| 2022 February | 14 | 23 | 37 |
| 2022 January | 18 | 36 | 54 |
| 2021 December | 17 | 54 | 71 |
| 2021 November | 13 | 45 | 58 |
| 2021 October | 27 | 53 | 80 |
| 2021 September | 16 | 66 | 82 |
| 2021 August | 13 | 28 | 41 |
| 2021 July | 15 | 34 | 49 |
| 2021 June | 9 | 26 | 35 |
| 2021 May | 13 | 24 | 37 |
| 2021 April | 39 | 75 | 114 |
| 2021 March | 23 | 19 | 42 |
| 2021 February | 9 | 20 | 29 |
| 2021 January | 10 | 14 | 24 |
| 2020 December | 11 | 17 | 28 |
| 2020 November | 13 | 16 | 29 |
| 2020 October | 8 | 8 | 16 |
| 2020 September | 3 | 6 | 9 |
| 2020 August | 7 | 12 | 19 |
| 2020 July | 13 | 17 | 30 |
| 2020 June | 12 | 3 | 15 |
| 2020 May | 9 | 16 | 25 |
| 2020 April | 17 | 22 | 39 |
| 2020 March | 7 | 13 | 20 |
| 2020 February | 15 | 24 | 39 |
| 2020 January | 9 | 17 | 26 |
| 2019 December | 13 | 16 | 29 |
| 2019 November | 9 | 12 | 21 |
| 2019 October | 4 | 10 | 14 |
| 2019 September | 3 | 15 | 18 |
| 2019 August | 15 | 10 | 25 |
| 2019 July | 13 | 18 | 31 |
| 2019 June | 5 | 4 | 9 |
| 2019 May | 10 | 20 | 30 |
| 2019 April | 18 | 31 | 49 |
| 2019 March | 8 | 22 | 30 |
| 2019 February | 8 | 8 | 16 |
| 2019 January | 7 | 13 | 20 |
| 2018 December | 8 | 11 | 19 |
| 2018 November | 23 | 19 | 42 |
| 2018 October | 40 | 15 | 55 |
| 2018 September | 12 | 11 | 23 |
| 2018 May | 10 | 1 | 11 |
| 2018 April | 11 | 7 | 18 |
| 2018 March | 3 | 4 | 7 |
| 2018 February | 3 | 7 | 10 |
| 2018 January | 3 | 5 | 8 |
| 2017 December | 4 | 5 | 9 |
| 2017 November | 1 | 5 | 6 |
| 2017 October | 3 | 7 | 10 |
| 2017 September | 7 | 5 | 12 |
| 2017 August | 6 | 10 | 16 |
| 2017 July | 5 | 5 | 10 |
| 2017 June | 10 | 17 | 27 |
| 2017 May | 4 | 4 | 8 |
| 2017 April | 3 | 8 | 11 |
| 2017 March | 5 | 2 | 7 |
| 2017 February | 2 | 3 | 5 |
| 2017 January | 2 | 3 | 5 |
| 2016 December | 5 | 4 | 9 |
| 2016 November | 12 | 8 | 20 |
| 2016 October | 11 | 6 | 17 |
| 2016 September | 10 | 5 | 15 |
| 2016 August | 11 | 2 | 13 |
| 2016 July | 13 | 5 | 18 |
| 2016 March | 2 | 0 | 2 |
| 2015 December | 2 | 0 | 2 |
| 2015 October | 42 | 13 | 55 |
| 2015 September | 43 | 12 | 55 |
| 2015 August | 49 | 8 | 57 |
| 2015 July | 31 | 15 | 46 |
| 2015 June | 34 | 6 | 40 |
| 2015 May | 51 | 14 | 65 |
| 2015 April | 28 | 14 | 42 |
| 2015 March | 21 | 8 | 29 |
| 2015 February | 32 | 3 | 35 |
| 2015 January | 26 | 4 | 30 |
| 2014 December | 34 | 7 | 41 |
| 2014 November | 34 | 7 | 41 |
| 2014 October | 56 | 12 | 68 |
| 2014 September | 39 | 7 | 46 |
| 2014 August | 38 | 9 | 47 |
| 2014 July | 28 | 11 | 39 |
| 2014 June | 36 | 6 | 42 |
| 2014 May | 50 | 12 | 62 |
| 2014 April | 47 | 5 | 52 |
| 2014 March | 55 | 12 | 67 |
| 2014 February | 31 | 9 | 40 |
| 2014 January | 33 | 9 | 42 |
| 2013 December | 42 | 8 | 50 |
| 2013 November | 34 | 6 | 40 |
| 2013 October | 40 | 8 | 48 |
| 2013 September | 38 | 10 | 48 |
| 2013 August | 29 | 8 | 37 |
| 2013 July | 50 | 7 | 57 |
| 2013 June | 31 | 11 | 42 |
| 2013 May | 50 | 10 | 60 |
| 2013 April | 17 | 6 | 23 |
| 2013 March | 7 | 1 | 8 |
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