Prevalence and Characterisation of Patients with Asthma According to Disease Severity in Portugal: Findings from the EPI-ASTHMA Pilot Study

Figures & data

Table 1 Brief Summary of the Data Collection Across Each Stage of the Pilot Study

	Stage 1	Stage 2	Stage 3
Sociodemographic and anthropometric characteristics	×	×
Brief PA assessment	×	×
Respiratory symptoms (wheeze, breathlessness)	×	×	×
Diagnosis of chronic respiratory disease	×	×	×
Comorbidities and allergies	×	×	×
Smoking habits and ETS	×	×
A2 Score	×
Inhaler prescription/use	×
Signs of asthma	×	×
CARAT		×	×
Asthma pharmacological treatment		×	×*
Inhalation technique		×
Adherence to inhaled medication		×	×*
Other treatments		×	×
Number of exacerbations		×	×*
Number of hospital admissions and length of hospital stay		×	×*
Number of unscheduled consultations		×	×*
Referral for specialist care		×	×*
Standard measurements (blood pressure, height, weight)		×
Pre-BD and post-BD lung function		×
Pulmonary diagnostic tests (previously performed)			×
FeNO		×
Peripheral blood eosinophil and neutrophil counts		×
Use of health and fitness apps	×	×
CARATm app use and opinion			×

Notes: *In the previous 3 and 12 months.

Abbreviations: PA, Brief physical activity assessment;^29,30 ETS, Environmental tobacco smoke; A2 Score, adult asthma epidemiological score;¹⁷ CARAT, Control of Allergic Rhinitis and Asthma Test;²⁰ Spirometry pre- and post-bronchodilator;³¹ FeNO, Fractional exhaled nitric oxide.³²

Figure 1 Flow of participants through study.

Table 2 Socio-Demographic and Clinical Characteristics of the Participants at Stage 1

	Total (N = 574)	Eligible (N = 181)	Not Eligible (N = 393)	P-value
Age, median (IQR, range)	53 (42–67) [18–89]	50 (39–66) [19–89]	54 (43–67)^a [18–87]	0.15
Male, N (%)	246 (42.9)	69 (38.1)	177 (45.0)^a	0.13
Marital status, N (%)				0.36
Married/partnership	353 (61.5)	109 (60.2)	244 (62.1)
Single	115 (20.0)	39 (21.5)	76 (19.3)
Divorced/separated	64 (11.1)	16 (8.8)	48 (12.2)
Widowed	42 (7.3)	17 (9.4)	25 (6.4)
Education, grade, N (%)				0.34
≤9th	174 (30.3)	59 (32.6)	115 (29.3)
10th–12th	232 (40.4)	79 (43.6)	153 (38.9)
>12th	168 (29.3)	43 (23.8)	125 (31.8)
Occupational status, N (%)				0.54
Employee	320 (55.7)	100 (55.2)	220 (56.0)
Retired	174 (30.3)	49 (27.1)	125 (31.8)
Unemployed	56 (9.8)	23 (12.7)	33 (8.4)
Student	18 (3.1)	7 (3.9)	11 (2.8)
Other	6 (1.0)	2 (1.1)	4 (1.0)
BMI, kg/m^2 median (IQR)	26 (23–29)	26 (23–30)^a	25 (23–29)^b	0.04*
BMI, classification N (%)				0.09
Underweight (<18.5)	5 (0.9)	4 (2.2)	1 (0.3)
Normal weight (18.5–24.9)	242 (42.2)	65 (35.9)	177 (45.0)
Overweight (25–29.9)	210 (36.6)	67 (37.0)	143 (36.4)
Obese (>30)	114 (19.9)	44 (24.3)	70 (17.8)
Insufficiently active, N (%)	358 (62.4)	112 (61.9)	246 (62.6)^c	0.31
Smoking status, N (%)				0.06
Former smoker	163 (28.4)	45 (24.9)^a	118 (30.0)^b
Current smoker	125 (21.8)	50 (27.6)	75 (19.1)
Never-smoked	282 (49.1)	86 (47.5)	196 (49.9)
ETS, N (%)	121 (21.1)	53 (29.3)	68 (17.3)^d	0.44
Asthma family history, N (%)	247 (43.0)	105 (58.0)	142 (36.1)	0.43
Self-reported Asthma, N (%)	95 (16.6)	95 (16.6)	-	-
Self-reported inhaler use, N (%)	72 (12.5)	72 (12.5)	-	-

Notes: *p < 0.05; ^a1 missing value; ^b2 missing values; ^c4 missing values; ^d5 missing values.

Abbreviations: BMI, body mass index; ETS, environmental tobacco smoke.

Table 3 Socio-Demographic and Clinical Characteristics of the Participants at Stage 2

	Total (N = 148)	Asthma (N = 46)	No Asthma (N = 102)	P-value
Age, median (IQR, range)	60 (46–68) [19–89]	51 (39–67) [19–82]	63 (48–68) [19–89]	0.02*
Male, N (%)	64 (43.2)	20 (43.4)	44 (43.1)	0.31
Marital status, N (%)				0.46
Married/partnership	105 (71.0)	29 (63.0)	76 (74.5)
Single	20 (13.5)	9 (19.6)	11 (10.8)
Divorced/separated	11 (7.4)	4 (8.7)	7 (6.8)
Widowed	12 (8.1)	4 (8.7)	8 (7.8)
Education, grade, N (%)				0.47
≤9th	56 (37.8)	14 (30.4)	42 (41.2)
10th–12th	58 (39.2)	18 (39.1)	39 (38.2)
>12th	34 (23.0)	14 (30.4)	20 (19.6)
Occupational status, N (%)				0.18
Employee	68 (45.9)	26 (56.5)	42 (41.1)
Retired	58 (39.2)	15 (32.6)	43 (42.2)
Unemployed	17 (11.5)	2 (4.3)	13 (13.0)
Student	3 (2.0)	2 (4.3)	1 (1.0)
Other	2 (1.5)	1 (2.2)	3 (3.0)
BMI, kg/m^2 median (IQR)	27 (24–30)	28 (24–30)	26 (24–30)	0.48
BMI, classification N (%)				0.74
Underweight (<18.5)	1 (0.7)	-	1 (1.0)
Normal weight (18.5–24.9)	50 (33.8)	17 (37)	33 (32.4)
Overweight (25–29.9)	58 (39.2)	15 (32.6)	43 (42.2)
Obese (>30)	39 (26.4)	14 (30.4)	25 (24.5)
Insufficiently active, N (%)	90 (60.8)	25 (54.3)	65 (64.0)	0.28
Smoking status, N (%)				0.26
Former smoker	45 (30.4)	14 (30.4)	31 (30.3)
Current smoker	34 (23.0)	5 (10.9)	29 (28.4)
Never-smoked	69 (46.6)	27 (58.7)	42 (41.2)
ETS, N (%)	39 (26.4)	9 (19.6)	30 (29.4)	0.23
Asthma family History, N (%)	79 (53.4)	31 (67.4)	48 (47.0)	0.39
Comorbidities, N (%)
Atopic dermatitis	19 (12.8)	6 (13.0)	13 (12.7)	0.31
OSA	10 (6.8)	2 (4.3)	8 (7.8)	0.20
GERD	39 (26.4)	9 (19.6)	30 (29.4)	0.23
Heart failure	10 (6.8)	1 (2.2)	9 (8.8)	0.10
Anxiety/depression	60 (40.5)	16 (34.8)	44 (43.1)	0.26
Others	98 (66.2)	31 (67.4)	67 (66.0)	0.34
Childhood respiratory symptoms, N (%)	33 (22.3)	19 (41.3)	14 (13.7)	0.58
FeNO (ppb), N (%)^a				<0.01*
<25	87 (58.8)	14 (30.4)	73 (71.6)
[25–50]	41 (27.7)	20 (43.5)	21 (20.6)
>50	12 (8.1)	9 (19.6)	3 (2.9)
Eosinophils, N (%)^b				<0.01*
>0.3 × 10^9/L	12 (8.1)	9 (19.6)	3 (2.9)
≤0.3 × 10^9/L	88 (59.5)	25 (54.3)	63 (61.8)
Spirometry parameters^c
Pre-bronchodilator, mean (SD)
FEV1% predicted	90 (20.0)	86 (23.9)	91 (17.9)	0.25
FVC % predicted	90 (20.1)	91 (24.2)	90 (16.2)	0.84
FEV1/FVC (%)	79 (7.8)	77 (8.7)	79 (7.7)	0.13
Post-bronchodilator, mean (SD)
FEV1% predicted	93 (19.0)	92 (23.7)	93 (16.6)	0.79
FVC % predicted	92 (18.1)	93 (24.7)	91 (14.4)	0.57
FEV1/FVC (%)	80 (8.0)	79 (8.9)	81 (7.5)	0.32
Positive bronchodilator response, N (%)	10 (6.8.)	6 (13.0)	4 (3.9)	0.60

Notes: *p<0.05; ^aParticipant refused test or experienced test fatigue (N = 8); ^bEquipment failure did not record value (N = 48); ^cParticipants did not meet the absolute contraindications for performing spirometry (N = 5). Positive bronchodilator response was defined as post-bronchodilator increase of ≥12% and an absolute change of >200 mL from the baseline FEV_1.

Abbreviations: BMI, body mass index; ETS, environmental tobacco smoke; OSA, obstructive sleep apnoea; GERD, gastroesophageal reflux disease; FeNO, concentration of exhaled nitric oxide; FEV₁, forced exhalation volume in one second; FVC, forced vital capacity.

Figure 2 Clinical characteristics of patients with asthma, at stage 2 and 3 (N = 41).

Abbreviations: VAS, Visual Analogue Scale; GINA, Global Initiative for Asthma; CARAT, Control of Allergic Rhinitis and Asthma Test.

Figure 3 Waffle chart with the proportion of asthma patients per subset of asthma severity.

Abbreviation: GINA, Global Initiative for Asthma.

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