Anna Porcu

ARIA-suggested drugs for allergic rhinitis: what impact on quality of life? A GA2LEN Review

Allergic diseases constitute a global health problem, as they have an increasing economic and social impact and, especially, they can deeply interfere with the patients’ daily life, being a cause of physical and emotional discomfort. This is why the health‐related quality‐of‐life (HRQoL) has become increasingly important in health care research; in fact, the assessment of the impact the disease and its treatment have on patients, provides a more comprehensive approach in outcome evaluation. Numerous validated questionnaires are available and many studies have been performed evaluating HRQoL in people affected by allergic rhinitis (AR), thus testifying a great interest in this topic. The aims of the present review are: to examine the scientific literature of the last 3 years dealing with the impact of AR treatments suggested by allergic rhinitis and its impact on asthma guidelines on patients’ QoL, and to identify the unexplored or not‐fully‐investigated areas concerning this issue.

Quality of Life in Duchenne Muscular Dystrophy: The Subjective Impact on Children and Parents

Duchenne muscular dystrophy results in a broad spectrum of physical and psychosocial consequences, both to patient and caregivers. This study was aimed to explore health-related quality of life and its possible determinants in Duchenne muscular dystrophy children and in their parents. Caregivers (21 mothers and 6 fathers; mean age, 40.04 years) of 27 Duchenne muscular dystrophy patients (mean age, 11.26 years) completed the validated Children Health Questionnaire-Parent Form 50 and the Family Strain Questionnaire. Children reported significantly lower scores than normative group in 10 of 15 Children Health Questionnaire dimensions. Only the use of wheelchairs (P = .02) and ventilators (P < .001) was significantly associated to lower health-related quality of life in Physical Functioning. On the contrary, Family Strain Questionnaire scores were not influenced by children’s characteristics. Despite the presence of Duchenne muscular dystrophy deeply impairs health-related quality of life, some areas of well-being are present both in children and caregivers.

Allergic rhinitis and asthma ad hoc survey: clinical and psychological perspectives

Background Several studies have provided evidence of a strong association between asthma and rhinitis, with consequences in terms of therapy and disease management.

An integrated disease management (IDM) programme of 12 months duration was effective for patients with COPD

Introduction/Objective: Massa-Carrara sanitary district implemented an IDM COPD programme. This study reviewed the data to see the impact of IDM on healthcare usage (respiratory related hospital admissions, hospital days length of stay, respiratory drugs and hospitalization costs). Methods: IDM shared among primary care, hospital chest physician and nurse care team, included educational program with individually tailored care plan, self-management plan, treatment supervision during scheduled visits, home visit and phone contact by specialized nurses. Results: Data were collected prospectively from successive patients referred for IDM between January 2012 and December 2013. 114 patients were recruited and stratified by clinical severity according to GOLD Standards criteria 2006. Over the 12 months of enrolment there was 72% mean reduction in COPD admissions (mean±SD: 0.17 ±0.4 compared to the first-year pre-enrolment 0.61 ±0.7, p=0.0001) and 73% reduction of hospital days. There was 41% ( p=0.001) average increase in respiratory drug cost (+ € 226) reflecting the effect of the IDM on drug adherence to inhaled medications while mean hospitalization cost fell by 69% (- € 1261),(p=0.001). IDM program was effective on all the GOLD stages. Results of multiple logistic regression analysis indicated that the best compliance to inhaled medications was found in patients who were older or had more severe airways obstruction. The best compliance to inhaled medications was found in GOLD stages III and IV. Conclusions: The IDM COPD program reduced respiratory related hospital admissions, improved compliance with respiratory drugs and achieved a saving on total disease cost.