Brazilian Journal of Pulmonology

ISSN (on-line): 1806-3756 | ISSN (printed): 1806-3713

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2020 Brazilian Thoracic Association recommendations for the management of asthma

Recomendações para o manejo da asma da Sociedade Brasileira de Pneumologia e Tisiologia - 2020

Marcia Margaret Menezes Pizzichini1, Regina Maria de Carvalho-Pinto2, José Eduardo Delfini Cançado3, Adalberto Sperb Rubin,4,5, Alcindo Cerci Neto6,7, Alexandre Pinto Cardoso8, Alvaro Augusto Cruz9,10, Ana Luisa Godoy Fernandes11, Daniella Cavalet Blanco12, Elcio Oliveira Vianna13, Gediel Cordeiro Junior14,15, José Angelo Rizzo16, Leandro Genehr Fritscher12, Lilian Serrasqueiro Ballini Caetano11, Luiz Fernando Ferreira Pereira17, Marcelo Fouad Rabahi18, Maria Alenita de Oliveira19, Marina Andrade Lima20, Marina Buarque de Almeida21, Rafael Stelmach2, Paulo Márcio Pitrez22, Alberto Cukier2

J Bras Pneumol.2020;46(1):e20190307-e20190307

Abstract PDF PT PDF EN Portuguese Text

The pharmacological management of asthma has changed considerably in recent decades, as it has come to be understood that it is a complex, heterogeneous disease with different phenotypes and endotypes. It is now clear that the goal of asthma treatment should be to achieve and maintain control of the disease, as well as to minimize the risks (of exacerbations, disease instability, accelerated loss of lung function, and adverse treatment effects). That requires an approach that is personalized in terms of the pharmacological treatment, patient education, written action plan, training in correct inhaler use, and review of the inhaler technique at each office visit. A panel of 22 pulmonologists was invited to perform a critical review of recent evidence of pharmacological treatment of asthma and to prepare this set of recommendations, a treatment guide tailored to use in Brazil. The topics or questions related to the most significant changes in concepts, and consequently in the management of asthma in clinical practice, were chosen by a panel of experts. To formulate these recommendations, we asked each expert to perform a critical review of a topic or to respond to a question, on the basis of evidence in the literature. In a second phase, three experts discussed and structured all texts submitted by the others. That was followed by a third phase, in which all of the experts reviewed and discussed each recommendation. These recommendations, which are intended for physicians involved in the treatment of asthma, apply to asthma patients of all ages.

 


Keywords: Asthma/therapy; Asthma/drug therapy; Asthma/prevention & control; Practice guideline.

 


Trend of self-reported asthma prevalence in Brazil from 2003 to 2013 in adults and factors associated with prevalence

Tendência da prevalência de asma autorreferida no Brasil de 2003 a 2013 em adultos e fatores associados à prevalência

Felipe Moraes dos Santos1,a, Karynna Pimentel Viana1,b, Luciana Tarbes Saturnino1,c, Evelyn Lazaridis1,d, Mariana Rodrigues Gazzotti1,e, Rafael Stelmach2,f, Claudia Soares1,g

J Bras Pneumol.2018;44(6):491-497

Abstract PDF PT PDF EN Portuguese Text

Objectives: To determine the trend of self-reported asthma diagnosed prevalence and to describe the factors associated with asthma in Brazilian adults. Method: Epidemiological cross-sectional study based on databases analysis from three national household surveys: Pesquisa Nacional por Amostra de Domicílios (PNAD) 2003, PNAD 2008 and Pesquisa Nacional de Saúde (PNS) 2013. Participants between 18-45 years old were included. Trend analysis of asthma diagnosed prevalence was conducted using a logistic general linear model. A hierarchical logistic regression model was used to select factors significantly associated with asthma prevalence. Results: Asthma diagnosed prevalence was 3.6% (2003), 3.7% (2008) and 4.5% (2013), showing a statistically significant increased trend. Asthma diagnosed prevalence also increased when analysed by gender (annual change for men: 2.47%, p < 0.003; women: 2.16%, p < 0.001), urban area (annual change for urban: 2.15%, p < 0.001; rural: 2.69%, p = 0.072), healthcare insurance status (annual change without healthcare insurance: 2.18%, p < 0.001; with healthcare insurance: 1.84%, p = 0.014), and geographic regions (annual change North: 4.68%, p < 0.001; Northeast: 4.14%, p < 0.001; and Southeast: 1.84%, p = 0.025). Female gender, obesity, living in urban areas and depression were associated with asthma diagnosed prevalence. Discussion: PNAD and PNS surveys allow for a very large, representative community-based sample of the Brazilian adults to investigate the asthma prevalence. From 2003 to 2013, the prevalence of self-reported physician diagnosis of asthma increased, especially in the North and Northeast regions. Gender, region of residence, household location (urban/rural), obesity, and depression diagnosis seem to play significant roles in the epidemiology of asthma in Brazil.

 


Keywords: Adults; Asthma; Logistic models; Prevalence; Risk factors.

 


 

 


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CNPq, Capes, Ministério da Educação, Ministério da Ciência e Tecnologia, Governo Federal, Brasil, País Rico é País sem Pobreza
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E-mails: jbp@jbp.org.br
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