TY - JOUR
T1 - Identification of clusters of asthma control: A preliminary analysis of the inspirers studies
AU - Jácome, Cristina
AU - Amaral, Rita
AU - Almeida, Rute
AU - Pereira, Ana Margarida
AU - Couto, Mariana
AU - Araújo, Luís
AU - Alves-Correia, Magna
AU - Pereira, Mariana
AU - Ferreira-Magalhães, Manuel
AU - Loureiro, Cláudia Chaves
AU - Catarata, Maria Joana
AU - Santos, Lília Maia
AU - Cabral, Sara
AU - Pereira, João
AU - Ramos, Bárbara
AU - Lopes, Cristina
AU - Mendes, Ana
AU - Lopes, Anabela
AU - Rodrigues, José Carlos Cidrais
AU - Oliveira, Georgeta
AU - Aguiar, Ana Paula
AU - Afonso, Ivete
AU - Carvalho, Joana
AU - Arrobas, Ana Maria
AU - Costa, José
AU - Valério, Margarida
AU - Pereira, Marta
AU - Almeida, Teresa
AU - Dias, Joana
AU - Bom, Ana Todo
AU - Azevedo, João
AU - Ribeiro, Carmelita
AU - Alves, Marta
AU - Pinto, Paula Leiria
AU - Neuparth, Nuno
AU - Neves, Ana Castro
AU - Palhinha, Ana
AU - Marques, João Gaspar
AU - Martins, Pedro
AU - Trincão, David Pina
AU - Bom, Filipa Todo
AU - Santos, Maria Alvarenga
AU - Branco, Joana
AU - Costa, Alberto
AU - Neto, Armandina Silva
AU - Santalha, Marta
AU - Lozoya, Carlos
AU - Santos, Natacha
AU - Silva, Diana
AU - Vasconcelos, Maria João
AU - Barata, Luís Taborda
AU - Teixeira, Maria Fernanda
AU - Pinto, Diana
AU - Alves, Rodrigo Rodrigues
AU - Moreira, Ana Sofia
AU - Pinto, Cláudia Sofia
AU - Silva, Pedro Morais
AU - Alves, Carlos
AU - Câmara, Raquel
AU - Coelho, Didina
AU - Bordalo, Diana
AU - Carvalho, Fernanda
AU - Fernandes, Ricardo
AU - Ferreira, Rosário
AU - de Oliveira, José Ferraz
AU - Menezes, Fernando
AU - Gomes, Ricardo
AU - Calix, Maria José
AU - Marques, Ana
AU - Cardoso, João
AU - Emiliano, Madalena
AU - Gerardo, Rita
AU - Nunes, Carlos
AU - Ferreira, José Alberto
AU - Lopes, Inês
AU - Alves, Adelaide
AU - Fonseca, João Almeida
N1 - This work was funded by ERDF (European Regional Development Fund) through the operations: POCI- -01-0145-FEDER-029130 (“mINSPIRERS—mHealth to measure and improve adherence to medication in chronic obstructive respiratory diseases - generalisation and evaluation of gamification, peer support and advanced image processing technologies”) co-funded by the COMPETE2020 (Programa Operacional Competitividade e Internacionalização), Portugal 2020 and by Portuguese Funds through FCT (Fundação para a Ciência e a Tecnologia).
PY - 2020
Y1 - 2020
N2 - © 2020, Sociedade Portuguesa de Alergologia e Imunologia Clinica. All rights reserved. Aims: To identify distinct asthma control clusters based on Control of Allergic Rhinitis and Asthma Test (CARAT) and to compare patients’ characteristics among these clusters. Methods: Adults and adolescents (≥13 years) with persistent asthma were recruited at 29 Portuguese hospital outpatient clinics, in the context of two observational studies of the INSPIRERS project. Demographic and clinical characteristics, adherence to inhaled medication, beliefs about inhaled medication, anxiety and depression, quality of life, and asthma control (CARAT, >24 good control) were collected. Hierarchical cluster analysis was performed using CARAT total score (CARAT-T). Results: 410 patients (68% adults), with a median (percentile 25–percentile 75) age of 28 (16-46) years, were analysed. Three clusters were identified [mean CARAT-T (min-max)]: cluster 1 [27(24-30)], cluster 2 [19(14-23)] and cluster 3 [10(2-13)]. Patients in cluster 1 (34%) were characterised by better asthma control, better quality of life, higher inhaler adherence and use of a single inhaler. Patients in clusters 2 (50%) and 3 (16%) had uncontrolled asthma, lower inhaler adherence, more symptoms of anxiety and depression and more than half had at least one exacerbation in the previous year. Further-more, patients in cluster 3 were predominantly female, had more unscheduled medical visits and more anxiety symp-toms, perceived a higher necessity of their prescribed inhalers but also higher levels of concern about taking these inhalers. There were no differences in age, body mass index, lung function, smoking status, hospital admissions or specialist physician follow-up time among the three clusters. Conclusion: An unsupervised method based on CARAT--T, identified 3 clusters of patients with distinct, clinically meaningful characteristics. The cluster with better asthma control had a cut-off similar to the established in the validation study of CARAT and an additional cut-off seems to distinguish more severe disease. Further research is necessary to validate the asthma control clusters identified.
AB - © 2020, Sociedade Portuguesa de Alergologia e Imunologia Clinica. All rights reserved. Aims: To identify distinct asthma control clusters based on Control of Allergic Rhinitis and Asthma Test (CARAT) and to compare patients’ characteristics among these clusters. Methods: Adults and adolescents (≥13 years) with persistent asthma were recruited at 29 Portuguese hospital outpatient clinics, in the context of two observational studies of the INSPIRERS project. Demographic and clinical characteristics, adherence to inhaled medication, beliefs about inhaled medication, anxiety and depression, quality of life, and asthma control (CARAT, >24 good control) were collected. Hierarchical cluster analysis was performed using CARAT total score (CARAT-T). Results: 410 patients (68% adults), with a median (percentile 25–percentile 75) age of 28 (16-46) years, were analysed. Three clusters were identified [mean CARAT-T (min-max)]: cluster 1 [27(24-30)], cluster 2 [19(14-23)] and cluster 3 [10(2-13)]. Patients in cluster 1 (34%) were characterised by better asthma control, better quality of life, higher inhaler adherence and use of a single inhaler. Patients in clusters 2 (50%) and 3 (16%) had uncontrolled asthma, lower inhaler adherence, more symptoms of anxiety and depression and more than half had at least one exacerbation in the previous year. Further-more, patients in cluster 3 were predominantly female, had more unscheduled medical visits and more anxiety symp-toms, perceived a higher necessity of their prescribed inhalers but also higher levels of concern about taking these inhalers. There were no differences in age, body mass index, lung function, smoking status, hospital admissions or specialist physician follow-up time among the three clusters. Conclusion: An unsupervised method based on CARAT--T, identified 3 clusters of patients with distinct, clinically meaningful characteristics. The cluster with better asthma control had a cut-off similar to the established in the validation study of CARAT and an additional cut-off seems to distinguish more severe disease. Further research is necessary to validate the asthma control clusters identified.
KW - Asthma
KW - Asthma control
KW - Classification
KW - Cluster analysis
KW - Control of allergic rhinitis and asthma test
UR - http://www.scopus.com/inward/record.url?scp=85097973162&partnerID=8YFLogxK
U2 - 10.32932/rpia.2020.12.046
DO - 10.32932/rpia.2020.12.046
M3 - Article
AN - SCOPUS:85097973162
SN - 0871-9721
VL - 28
SP - 231
EP - 240
JO - Revista Portuguesa de Imunoalergologia
JF - Revista Portuguesa de Imunoalergologia
IS - 4
ER -