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202 Thermo Fisher ImmunoCAP > Asthma > Flashcards

Asthma Flashcards

1
Q

The benefits of specific IgE testing in the primary care setting

Author
Journal

A

Kwong

American Journal of Managed Care (AJMC)

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2
Q

% of patients with allergy-like symptoms treated in primary care setting

A

80%

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3
Q

Percent of asthmatics treated in primary care

A

76%

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4
Q

Kwong: $ spent on AR and Asthmatics

A 
AR= $7.3 Billion
Asthma= $37.2 Billion
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5
Q

% of adults and children who have allergic triggers

A

60% adults

90% children

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6
Q

Kwong: % of patients with eczema who have underlying allergic disease

A

30-40%

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7
Q

Advantages of SPT

A
  • Results available within 1 hour
  • Equally as sensitive as in vitro tests
  • Can be less expensive than in vitro tests
  • Results are visible to patients, which may encourage compliance with environmental control measures
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8
Q

Advantages of In Vitro Tests

A
  • No need for testing technique
  • No need for allergen extracts
  • Patients can continue medications
  • No risk for systematic rx (anaphylaxis)
  • Can do for pts with eczema
  • Quantitative results with established 95% cutoff values
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9
Q

REACT Study
What does it stand for?
Which Journal?

A

Real World Evaluation of Asthma Control and Tx

Journal of Allergy and Clinical Immunology

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10
Q

Who was the author of the REACT study

A

Peters et all

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11
Q

Primary objective of the REACT study

A

Web based survey to asthmatics who were on multiple controller meds to assess the prevalence of uncontrolled asthma in the US

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12
Q

Key Numbers from the REACT study
# of patients
% controlled vs uncontrolled
% of patients with healthcare coverage

A

1812 patients
45% controlled
55% uncontrolled
88% had healthcare coverage

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13
Q

REACT study bottom line

A

Need for improved asthma care, better asthma control, need for implementation of asthma treat plans, need for better management of co-morbid conditions such as rhinosinusitis

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14
Q

Rules of Two

A
  • Using rescue inhaler > 2x/week
  • Waking up due to asthma > 2x/month
  • Refilling rescue meds > 2x/year
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15
Q

NIH Guidelines two pronged approach

A

1) Meds alone NOT enough and Targeted exposure works
2) Category A Evidence that persistent asthmatics should be evaluated about the potential role of allergens- particularly indoor allergens

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16
Q

NIH Guidelines: Most important step in tx of asthma

A

Identify allergic triggers

17
Q

NIH guidelines: 4 Components of comprehensive asthma management

A

1) Assessment & Monitoring
2) Controlling allergic/non allergic triggers
3) Pharmacotherapy
4) Education (patient and family)

18
Q

Effect of mattered and pillow encasing on children with asthma and house dust mite allergy
Who authored?
Which Journal?

A

Halken et all

Journal of Allergy and Clinical Immunology

19
Q

Halken:
N=__?
Age range
Monitored for how long?

A

N=60
6-15 years old
Monitored for 1 year

20
Q

Halken key results

A

73% of patients in control group with HDM covers reduced their dosage of inhaled steroids by at least 50%

Bottom line: Targeted Exposure Reductions works and leads to reductions in medications

21
Q

Results of a home-based environmental intervention among urban children with asthma (Inner city Study)
Author?
Journal?

A

Morgan et all

New England Journal of Medicine (NEJM)

22
Q

Morgan study objective

A

To establish that environmental control measures improves outcomes in children with asthma

23
Q

Morgan
N=__?
Age range
Demographics

A

N= 937 patients
5-11 years old
Children from 7 major cities for 1 year (+1 year follow up)

24
Q

Morgan study objective

A

Establish that environmental control measures improve outcomes in children with asthma

25
Q 
Morgan study intervention group results:
lost school days
Children's lost sleep
Fewer unscheduled visits
Fewer days with symptoms
A

4.4 fewer days of missed school
5.5 fewer less sleep days
2.1 fewer unscheduled visits per year
21.3 fewer days with symptoms
17 fewer days of wheezing (this is not Morgan but from veeva)

26
Q

How many people have asthma?

A

25.9 million or also 24.6 million?

1 in 14 people

27
Q

Asthma death stats and rates to know

A 
9 ppl / day die
3600 per year
Equally distributed between mild, moderate and severe
65% are women
Rates 47% higher in blacks than whites
28
Q

Cost of asthma breakdown

A

$56 Billion total:

  • -> $50 B direct
  • -> $6 B indirect
29
Q

Percentage of allergic triggers in adults and children

A

60% adults

90% children

30
Q

Allergic rhinitis ranks __th most common disease overall

A

5th

31
Q

AR affects 1 in how many Americans?

A

1 in 6

32
Q

Percentage of patients polysensitized: Clinical Practice Guidelines for AR

A

90%

33
Q

AR Ranks __ th in most common diagnosis in primary care

A

16th

34
Q

SABA

A

Bronchodilators/Rescue Meds
NOT for long term use
I.e.) Albuterol

35
Q

Long Term: Persistent Asthma/Controller Meds

A

If Corticosteroids don’t work (preferred first line of tx)
Leukotriene modifiers
Combo: Advair & Symbicort- most commonly prescribed
Others: Cromolyn, Theophylline

36
Q

Histological changes that occur in asthmatic airways during inflammation

A

Contraction of airway smooth muscle
Airway wall hypertrophic and airway narrowing
Over-secretion of mucus

37
Q

__% children and __% adults with asthma are atopic

A

90%, 60%

38
Q

Only asthma medication indicated for use in allergic rhinitis

A

Singular

202 Thermo Fisher ImmunoCAP (1 decks)

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