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Identification of clusters of asthma control: A preliminary analysis of the Inspirers studies

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Resumo: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. Furthermore, patients in cluster 3 were predominantly female, had more unscheduled medical visits and more anxiety symptoms, 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.
Autores principais:Jácome,Cristina
Outros Autores:Amaral,Rita; Almeida,Rute; Pereira,Ana Margarida; Couto,Mariana; Araújo,Luís; Alves-Correia,Magna; Pereira,Mariana; Ferreira-Magalhães,Manuel; Loureiro,Cláudia Chaves; Catarata,Maria Joana; Santos,Lília Maia; Cabral,Sara; Pereira,João; Ramos,Bárbara; Lopes,Cristina; Mendes,Ana; Lopes,Anabela; Rodrigues,José Carlos Cidrais; Oliveira,Georgeta; Aguiar,Ana Paula; Afonso,Ivete; Carvalho,Joana; Arrobas,Ana Maria; Costa,José; Valério,Margarida; Pereira,Marta; Almeida,Teresa; Dias,Joana; Bom,Ana Todo; Azevedo,João; Ribeiro,Carmelita; Alves,Marta; Pinto,Paula Leiria; Neuparth,Nuno; Neves,Ana Castro; Palhinha,Ana; Marques,João Gaspar; Martins,Pedro; Trincão,David Pina; Todo-Bom,Filipa; Santos,Maria Alvarenga; Branco,Joana; Costa,Alberto; Neto,Armandina Silva; Santalha,Marta; Lozoya,Carlos; Santos,Natacha; Silva,Diana; Vasconcelos,Maria João; Barata,Luís Taborda; Teixeira,Maria Fernanda; Pinto,Diana; Alves,Rodrigo Rodrigues; Moreira,Ana Sofia; Pinto,Cláudia Sofia; Silva,Pedro Morais; Alves,Carlos; Câmara,Raquel; Coelho,Didina; Bordalo,Diana; Carvalho,Fernanda; Fernandes,Ricardo; Ferreira,Rosário; Oliveira,José Ferraz de; Menezes,Fernando; Gomes,Ricardo; Calix,Maria José; Marques,Ana; Cardoso,João; Emiliano,Madalena; Gerardo,Rita; Nunes,Carlos; Ferreira,José Alberto; Lopes,Inês; Alves,Adelaide; Fonseca,João Almeida
Assunto:Asthma asthma control classification cluster analysis control of allergic rhinitis and asthma test
Ano:2020
País:Portugal
Tipo de documento:artigo
Tipo de acesso:acesso aberto
Instituição associada:Fundação para a Ciência e Tecnologia
Idioma:inglês
Origem:SciELO Portugal
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author Jácome,Cristina
author2 Amaral,Rita
Almeida,Rute
Pereira,Ana Margarida
Couto,Mariana
Araújo,Luís
Alves-Correia,Magna
Pereira,Mariana
Ferreira-Magalhães,Manuel
Loureiro,Cláudia Chaves
Catarata,Maria Joana
Santos,Lília Maia
Cabral,Sara
Pereira,João
Ramos,Bárbara
Lopes,Cristina
Mendes,Ana
Lopes,Anabela
Rodrigues,José Carlos Cidrais
Oliveira,Georgeta
Aguiar,Ana Paula
Afonso,Ivete
Carvalho,Joana
Arrobas,Ana Maria
Costa,José
Valério,Margarida
Pereira,Marta
Almeida,Teresa
Dias,Joana
Bom,Ana Todo
Azevedo,João
Ribeiro,Carmelita
Alves,Marta
Pinto,Paula Leiria
Neuparth,Nuno
Neves,Ana Castro
Palhinha,Ana
Marques,João Gaspar
Martins,Pedro
Trincão,David Pina
Todo-Bom,Filipa
Santos,Maria Alvarenga
Branco,Joana
Costa,Alberto
Neto,Armandina Silva
Santalha,Marta
Lozoya,Carlos
Santos,Natacha
Silva,Diana
Vasconcelos,Maria João
Barata,Luís Taborda
Teixeira,Maria Fernanda
Pinto,Diana
Alves,Rodrigo Rodrigues
Moreira,Ana Sofia
Pinto,Cláudia Sofia
Silva,Pedro Morais
Alves,Carlos
Câmara,Raquel
Coelho,Didina
Bordalo,Diana
Carvalho,Fernanda
Fernandes,Ricardo
Ferreira,Rosário
Oliveira,José Ferraz de
Menezes,Fernando
Gomes,Ricardo
Calix,Maria José
Marques,Ana
Cardoso,João
Emiliano,Madalena
Gerardo,Rita
Nunes,Carlos
Ferreira,José Alberto
Lopes,Inês
Alves,Adelaide
Fonseca,João Almeida
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author_facet Jácome,Cristina
Amaral,Rita
Almeida,Rute
Pereira,Ana Margarida
Couto,Mariana
Araújo,Luís
Alves-Correia,Magna
Pereira,Mariana
Ferreira-Magalhães,Manuel
Loureiro,Cláudia Chaves
Catarata,Maria Joana
Santos,Lília Maia
Cabral,Sara
Pereira,João
Ramos,Bárbara
Lopes,Cristina
Mendes,Ana
Lopes,Anabela
Rodrigues,José Carlos Cidrais
Oliveira,Georgeta
Aguiar,Ana Paula
Afonso,Ivete
Carvalho,Joana
Arrobas,Ana Maria
Costa,José
Valério,Margarida
Pereira,Marta
Almeida,Teresa
Dias,Joana
Bom,Ana Todo
Azevedo,João
Ribeiro,Carmelita
Alves,Marta
Pinto,Paula Leiria
Neuparth,Nuno
Neves,Ana Castro
Palhinha,Ana
Marques,João Gaspar
Martins,Pedro
Trincão,David Pina
Todo-Bom,Filipa
Santos,Maria Alvarenga
Branco,Joana
Costa,Alberto
Neto,Armandina Silva
Santalha,Marta
Lozoya,Carlos
Santos,Natacha
Silva,Diana
Vasconcelos,Maria João
Barata,Luís Taborda
Teixeira,Maria Fernanda
Pinto,Diana
Alves,Rodrigo Rodrigues
Moreira,Ana Sofia
Pinto,Cláudia Sofia
Silva,Pedro Morais
Alves,Carlos
Câmara,Raquel
Coelho,Didina
Bordalo,Diana
Carvalho,Fernanda
Fernandes,Ricardo
Ferreira,Rosário
Oliveira,José Ferraz de
Menezes,Fernando
Gomes,Ricardo
Calix,Maria José
Marques,Ana
Cardoso,João
Emiliano,Madalena
Gerardo,Rita
Nunes,Carlos
Ferreira,José Alberto
Lopes,Inês
Alves,Adelaide
Fonseca,João Almeida
author_role author
country_str PT
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datacite.creators.creator.creatorName.fl_str_mv Jácome,Cristina
Amaral,Rita
Almeida,Rute
Pereira,Ana Margarida
Couto,Mariana
Araújo,Luís
Alves-Correia,Magna
Pereira,Mariana
Ferreira-Magalhães,Manuel
Loureiro,Cláudia Chaves
Catarata,Maria Joana
Santos,Lília Maia
Cabral,Sara
Pereira,João
Ramos,Bárbara
Lopes,Cristina
Mendes,Ana
Lopes,Anabela
Rodrigues,José Carlos Cidrais
Oliveira,Georgeta
Aguiar,Ana Paula
Afonso,Ivete
Carvalho,Joana
Arrobas,Ana Maria
Costa,José
Valério,Margarida
Pereira,Marta
Almeida,Teresa
Dias,Joana
Bom,Ana Todo
Azevedo,João
Ribeiro,Carmelita
Alves,Marta
Pinto,Paula Leiria
Neuparth,Nuno
Neves,Ana Castro
Palhinha,Ana
Marques,João Gaspar
Martins,Pedro
Trincão,David Pina
Todo-Bom,Filipa
Santos,Maria Alvarenga
Branco,Joana
Costa,Alberto
Neto,Armandina Silva
Santalha,Marta
Lozoya,Carlos
Santos,Natacha
Silva,Diana
Vasconcelos,Maria João
Barata,Luís Taborda
Teixeira,Maria Fernanda
Pinto,Diana
Alves,Rodrigo Rodrigues
Moreira,Ana Sofia
Pinto,Cláudia Sofia
Silva,Pedro Morais
Alves,Carlos
Câmara,Raquel
Coelho,Didina
Bordalo,Diana
Carvalho,Fernanda
Fernandes,Ricardo
Ferreira,Rosário
Oliveira,José Ferraz de
Menezes,Fernando
Gomes,Ricardo
Calix,Maria José
Marques,Ana
Cardoso,João
Emiliano,Madalena
Gerardo,Rita
Nunes,Carlos
Ferreira,José Alberto
Lopes,Inês
Alves,Adelaide
Fonseca,João Almeida
datacite.rights.fl_str_mv http://purl.org/coar/access_right/c_abf2
datacite.subjects.subject.fl_str_mv Asthma
asthma control
classification
cluster analysis
control of allergic rhinitis and asthma test
datacite.titles.title.fl_str_mv Identification of clusters of asthma control: A preliminary analysis of the Inspirers studies
dc.creator.none.fl_str_mv Jácome,Cristina
Amaral,Rita
Almeida,Rute
Pereira,Ana Margarida
Couto,Mariana
Araújo,Luís
Alves-Correia,Magna
Pereira,Mariana
Ferreira-Magalhães,Manuel
Loureiro,Cláudia Chaves
Catarata,Maria Joana
Santos,Lília Maia
Cabral,Sara
Pereira,João
Ramos,Bárbara
Lopes,Cristina
Mendes,Ana
Lopes,Anabela
Rodrigues,José Carlos Cidrais
Oliveira,Georgeta
Aguiar,Ana Paula
Afonso,Ivete
Carvalho,Joana
Arrobas,Ana Maria
Costa,José
Valério,Margarida
Pereira,Marta
Almeida,Teresa
Dias,Joana
Bom,Ana Todo
Azevedo,João
Ribeiro,Carmelita
Alves,Marta
Pinto,Paula Leiria
Neuparth,Nuno
Neves,Ana Castro
Palhinha,Ana
Marques,João Gaspar
Martins,Pedro
Trincão,David Pina
Todo-Bom,Filipa
Santos,Maria Alvarenga
Branco,Joana
Costa,Alberto
Neto,Armandina Silva
Santalha,Marta
Lozoya,Carlos
Santos,Natacha
Silva,Diana
Vasconcelos,Maria João
Barata,Luís Taborda
Teixeira,Maria Fernanda
Pinto,Diana
Alves,Rodrigo Rodrigues
Moreira,Ana Sofia
Pinto,Cláudia Sofia
Silva,Pedro Morais
Alves,Carlos
Câmara,Raquel
Coelho,Didina
Bordalo,Diana
Carvalho,Fernanda
Fernandes,Ricardo
Ferreira,Rosário
Oliveira,José Ferraz de
Menezes,Fernando
Gomes,Ricardo
Calix,Maria José
Marques,Ana
Cardoso,João
Emiliano,Madalena
Gerardo,Rita
Nunes,Carlos
Ferreira,José Alberto
Lopes,Inês
Alves,Adelaide
Fonseca,João Almeida
dc.format.none.fl_str_mv text/html
dc.identifier.none.fl_str_mv http://scielo.pt/scielo.php?script=sci_arttext&pid=S0871-97212020000400004
dc.language.none.fl_str_mv eng
dc.publisher.none.fl_str_mv Sociedade Portuguesa de Alergologia e Imunologia Clínica
dc.rights.none.fl_str_mv http://purl.org/coar/access_right/c_abf2
dc.source.none.fl_str_mv Revista Portuguesa de Imunoalergologia v.28 n.4 2020
dc.subject.none.fl_str_mv Asthma
asthma control
classification
cluster analysis
control of allergic rhinitis and asthma test
dc.title.fl_str_mv Identification of clusters of asthma control: A preliminary analysis of the Inspirers studies
dc.type.none.fl_str_mv http://purl.org/coar/resource_type/c_6501
description 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. Furthermore, patients in cluster 3 were predominantly female, had more unscheduled medical visits and more anxiety symptoms, 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.
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eu_rights_str_mv openAccess
format article
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identifier.url.fl_str_mv http://scielo.pt/scielo.php?script=sci_arttext&pid=S0871-97212020000400004
instacron_str SciELO
institution Fundação para a Ciência e Tecnologia
instname_str Fundação para a Ciência e Tecnologia
language eng
network_acronym_str scielopt
network_name_str SciELO Portugal
oai_identifier_str oai:scielo:S0871-97212020000400004
organization_str_mv urn:organizationAcronym:scielo
person_str_mv Jácome,Cristina
Amaral,Rita
Almeida,Rute
Pereira,Ana Margarida
Couto,Mariana
Araújo,Luís
Alves-Correia,Magna
Pereira,Mariana
Ferreira-Magalhães,Manuel
Loureiro,Cláudia Chaves
Catarata,Maria Joana
Santos,Lília Maia
Cabral,Sara
Pereira,João
Ramos,Bárbara
Lopes,Cristina
Mendes,Ana
Lopes,Anabela
Rodrigues,José Carlos Cidrais
Oliveira,Georgeta
Aguiar,Ana Paula
Afonso,Ivete
Carvalho,Joana
Arrobas,Ana Maria
Costa,José
Valério,Margarida
Pereira,Marta
Almeida,Teresa
Dias,Joana
Bom,Ana Todo
Azevedo,João
Ribeiro,Carmelita
Alves,Marta
Pinto,Paula Leiria
Neuparth,Nuno
Neves,Ana Castro
Palhinha,Ana
Marques,João Gaspar
Martins,Pedro
Trincão,David Pina
Todo-Bom,Filipa
Santos,Maria Alvarenga
Branco,Joana
Costa,Alberto
Neto,Armandina Silva
Santalha,Marta
Lozoya,Carlos
Santos,Natacha
Silva,Diana
Vasconcelos,Maria João
Barata,Luís Taborda
Teixeira,Maria Fernanda
Pinto,Diana
Alves,Rodrigo Rodrigues
Moreira,Ana Sofia
Pinto,Cláudia Sofia
Silva,Pedro Morais
Alves,Carlos
Câmara,Raquel
Coelho,Didina
Bordalo,Diana
Carvalho,Fernanda
Fernandes,Ricardo
Ferreira,Rosário
Oliveira,José Ferraz de
Menezes,Fernando
Gomes,Ricardo
Calix,Maria José
Marques,Ana
Cardoso,João
Emiliano,Madalena
Gerardo,Rita
Nunes,Carlos
Ferreira,José Alberto
Lopes,Inês
Alves,Adelaide
Fonseca,João Almeida
publishDate 2020
publisher.none.fl_str_mv Sociedade Portuguesa de Alergologia e Imunologia Clínica
reponame_str SciELO Portugal
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spelling Identification of clusters of asthma control: A preliminary analysis of the Inspirers studiesJácome,CristinaAmaral,RitaAlmeida,RutePereira,Ana MargaridaCouto,MarianaAraújo,LuísAlves-Correia,MagnaPereira,MarianaFerreira-Magalhães,ManuelLoureiro,Cláudia ChavesCatarata,Maria JoanaSantos,Lília MaiaCabral,SaraPereira,JoãoRamos,BárbaraLopes,CristinaMendes,AnaLopes,AnabelaRodrigues,José Carlos CidraisOliveira,GeorgetaAguiar,Ana PaulaAfonso,IveteCarvalho,JoanaArrobas,Ana MariaCosta,JoséValério,MargaridaPereira,MartaAlmeida,TeresaDias,JoanaBom,Ana TodoAzevedo,JoãoRibeiro,CarmelitaAlves,MartaPinto,Paula LeiriaNeuparth,NunoNeves,Ana CastroPalhinha,AnaMarques,João GasparMartins,PedroTrincão,David PinaTodo-Bom,FilipaSantos,Maria AlvarengaBranco,JoanaCosta,AlbertoNeto,Armandina SilvaSantalha,MartaLozoya,CarlosSantos,NatachaSilva,DianaVasconcelos,Maria JoãoBarata,Luís TabordaTeixeira,Maria FernandaPinto,DianaAlves,Rodrigo RodriguesMoreira,Ana SofiaPinto,Cláudia SofiaSilva,Pedro MoraisAlves,CarlosCâmara,RaquelCoelho,DidinaBordalo,DianaCarvalho,FernandaFernandes,RicardoFerreira,RosárioOliveira,José Ferraz deMenezes,FernandoGomes,RicardoCalix,Maria JoséMarques,AnaCardoso,JoãoEmiliano,MadalenaGerardo,RitaNunes,CarlosFerreira,José AlbertoLopes,InêsAlves,AdelaideFonseca,João AlmeidaAsthmaasthma controlclassificationcluster analysiscontrol of allergic rhinitis and asthma testopen accesshttp://purl.org/coar/access_right/c_abf2http://scielo.pt/scielo.php?script=sci_arttext&pid=S0871-97212020000400004URLhttp://scielo.pt/scielo.php?script=sci_arttext&pid=S0871-97212020000400004URLHasVersion2020-12-01Aims: 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. Furthermore, patients in cluster 3 were predominantly female, had more unscheduled medical visits and more anxiety symptoms, 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.Sociedade Portuguesa de Alergologia e Imunologia ClínicaRevista Portuguesa de Imunoalergologia v.28 n.4 2020text/htmlengjournal articlehttp://purl.org/coar/resource_type/c_6501literature
spellingShingle Identification of clusters of asthma control: A preliminary analysis of the Inspirers studies
Jácome,Cristina
Asthma
asthma control
classification
cluster analysis
control of allergic rhinitis and asthma test
status SINGLETON
subject.fl_str_mv Asthma
asthma control
classification
cluster analysis
control of allergic rhinitis and asthma test
title Identification of clusters of asthma control: A preliminary analysis of the Inspirers studies
title_full Identification of clusters of asthma control: A preliminary analysis of the Inspirers studies
title_fullStr Identification of clusters of asthma control: A preliminary analysis of the Inspirers studies
title_full_unstemmed Identification of clusters of asthma control: A preliminary analysis of the Inspirers studies
title_short Identification of clusters of asthma control: A preliminary analysis of the Inspirers studies
title_sort Identification of clusters of asthma control: A preliminary analysis of the Inspirers studies
topic Asthma
asthma control
classification
cluster analysis
control of allergic rhinitis and asthma test
topic_facet Asthma
asthma control
classification
cluster analysis
control of allergic rhinitis and asthma test
url http://scielo.pt/scielo.php?script=sci_arttext&pid=S0871-97212020000400004
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