Please use this identifier to cite or link to this item: https://doi.org/10.1038/npjpcrm.2015.64
Title: Ten-year longitudinal study of factors influencing nocturnal asthma symptoms among Asian patients in primary care
Authors: Tan, N.C 
Nadkarni, N.V 
Lye, W.K 
Sankari, U
Nguyen, V.H
Keywords: beta 2 adrenergic receptor stimulating agent
corticosteroid
antiasthmatic agent
beta 2 adrenergic receptor stimulating agent
corticosteroid
adult
age
allergic rhinitis
Article
Asian
asthma
coughing
data base
dyspnea
female
human
longitudinal study
major clinical study
male
medical record review
nocturnal asthma
physician
predictive value
primary medical care
race
retrospective study
risk assessment
smoking
wheezing
aged
Asian continental ancestry group
asthma
combination drug therapy
complication
Cough
drug substitution
dyspnea
inhalational drug administration
middle aged
pathophysiology
primary health care
Respiratory Sounds
Singapore
time factor
young adult
Administration, Inhalation
Adrenal Cortex Hormones
Adrenergic beta-2 Receptor Agonists
Adult
Aged
Anti-Asthmatic Agents
Asian Continental Ancestry Group
Asthma
Cough
Drug Substitution
Drug Therapy, Combination
Dyspnea
Female
Humans
Longitudinal Studies
Male
Middle Aged
Primary Health Care
Respiratory Sounds
Retrospective Studies
Rhinitis, Allergic
Singapore
Time Factors
Young Adult
Issue Date: 2015
Citation: Tan, N.C, Nadkarni, N.V, Lye, W.K, Sankari, U, Nguyen, V.H (2015). Ten-year longitudinal study of factors influencing nocturnal asthma symptoms among Asian patients in primary care. npj Primary Care Respiratory Medicine 25 : 15064. ScholarBank@NUS Repository. https://doi.org/10.1038/npjpcrm.2015.64
Abstract: Background:Nocturnal asthma symptoms result in poor quality of life and morbidity.Aims:This study primarily examines key factors predicting and mitigating nocturnal symptom risks among asthma patients, who were enrolled into a Singapore publicly funded asthma care programme. It also studies the association between nocturnal symptoms and medication changes as the secondary outcome.Methods:A longitudinal study was conducted on 939 multi-racial Asian patients with persistent asthma. Patient clinical and therapeutic data were retrieved retrospectively from the programme's database established in 2004. Association between nocturnal symptoms (defined as night-time cough, wheeze and breathlessness at least twice monthly) and each categorical predictor was tested. The generalised linear mixed-effects model (GLIMM) was used to model the primary and secondary outcomes.Results:Having nocturnal asthma symptoms was significantly associated with the number of days with breathlessness, off usual activities and off work, and asthma severity at baseline (all P values <0.05). The asthma action plan (AAP) status is significantly associated with nocturnal symptoms after adjusting for race, age and smoking status at baseline (odds ratio (OR)=0.49 (updated asthma action plan versus none), OR=0.37 (been-on plan versus none)). The risks of nocturnal asthma symptoms increased over time for those with allergic rhinitis (OR=1.52) and reduced with subsequent visits (OR=0.91). Nocturnal symptoms increased the odds (OR=2.87) of switching from inhaled corticosteroid (ICS) to combination medications (ICS-LABA (long-acting β 2 -agonist)).Conclusions:The risks of having nocturnal symptoms were primarily associated with those with allergic rhinitis. An increase in patients' nocturnal symptoms was also predictive of the switching from ICS medications to combination formulations by their physicians.
Source Title: npj Primary Care Respiratory Medicine
URI: https://scholarbank.nus.edu.sg/handle/10635/175979
ISSN: 2055-1010
DOI: 10.1038/npjpcrm.2015.64
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