Ute Langen

Prävalenz von Sensibilisierungen gegen Inhalations- und Nahrungsmittelallergene

In view of the increasing prevalence of allergies, up-to-date data on the prevalence of allergic sensitisation are of major interest. In the German Health Interview and Examination Survey for Adults (DEGS1) (2008-2011) blood samples from a population-based sample of 7,025 participants aged 18 to 79 years were analysed for specific IgE antibodies against 50 common single allergens and screened for common aeroallergens (SX1) and grass pollen (GX1). In all, 48.6 % of the participants were sensitised to at least one allergen. Overall, men were more frequently sensitised to at least one allergen than women were. Sensitisations to at least one allergen were more common among younger than older participants and among participants with a higher socio-economic status. In all, 33.6 % of the participants were sensitised to common aeroallergens, 25.5  % to food allergens and 22.6 % to wasp or bee venoms. Compared with the German National Health Interview and Examination Survey 1998 (GNHIES98), the prevalence of sensitisation to common aeroallergens increased from 29.8 to 33.6 %.This increase was statistically significant only in women. The results of DEGS1 still showed a high prevalence of allergic sensitisation. An English full-text version of this article is available at SpringerLink as supplemental.

Häufigkeit allergischer Erkrankungen in Deutschland

ZusammenfassungIn der ersten Welle der „Studie zur Gesundheit Erwachsener in Deutschland“ (DEGS1) wurden aktuelle und bundesweit repräsentative Daten zum allergischen Krankheitsgeschehen von 7988 18- bis 79-Jährigen mittels computergestützter, ärztlicher Interviews erhoben. Demnach liegt die Lebenszeitprävalenz (LZP) für Asthma bronchiale bei 8,6%, Heuschnupfen bei 14,8%, Neurodermitis und Urtikaria bei jeweils 3,5%, Kontaktekzeme bei 8,1%, Nahrungsmittelallergien bei 4,7% und Insektengiftallergien bei 2,8%. Insgesamt ist bei einem knappen Drittel der Erwachsenen mindestens eine der genannten Allergien jemals ärztlich diagnostiziert worden. Aktuell leiden fast 20% an mindestens einer Allergie. Frauen sind generell häufiger betroffen als Männer und Jüngere häufiger als Ältere. Außerdem sind Allergien in den alten Bundesländern verbreiteter als in den neuen. Ein hoher sozioökonomischer Status und das Leben in Großstädten erhöhen ebenfalls die Krankheitshäufigkeit. Im 10-Jahres-Trend stieg die Asthmaprävalenz um knapp 3%, die Prävalenzen für Urtikaria und Kontaktekzeme sanken, die LZP für Heuschnupfen, Neurodermitis und Nahrungsmittelallergie blieb unverändert. Dadurch ist die Allergieprävalenz insgesamt von 32,7% auf 28,7% rückläufig.AbstractIn the first wave of the “German Health Interview and Examination Survey for Adults” (DEGS1), up-to-date and representative data regarding allergic diseases of 7988 18- to 79-year-old subjects living in Germany were collected using computer-assisted medical interviews. The study identified a lifetime prevalence of 8.6% for asthma, 14.8% for allergic rhinoconjunctivitis, 3.5% each for atopic dermatitis and urticaria, 8.1% for contact eczema, 4.7% for food allergies and 2.8% for insect venom allergies. Overall, nearly one third of adults in Germany have been diagnosed with at least one of the above mentioned allergies during their lifetime by a physician. Currently, nearly 20% suffer from at least one allergic disease. Generally, women reported an allergic disease more frequently than men and younger subjects more frequently than older ones. Additionally, allergies are more common in the former federal states of West Germany than in the former East German federal states. A high socioeconomic status and living in large cities both increase allergy risk. During the last 10 years, asthma prevalence increased about 3%, whereas the prevalence of urticaria and contact eczema declined. The lifetime prevalence of allergic rhinoconjunctivitis, atopic dermatitis and food allergies appeared unchanged. In total, allergy prevalence has declined from 32.7–28.7% over the past decade. An English full-text version of this article is available at SpringerLink as supplemental.

Chronic disease co-morbidity of asthma and unscheduled asthma care among adults: results of the national telephone health interview survey German Health Update (GEDA) 2009 and 2010.

Background: Co-morbidities may complicate the clinical management of chronic conditions such as asthma. Aims: To quantify the strength of the relationship between asthma and other chronic diseases and to analyse whether co-morbidities contribute to unscheduled asthma care. Methods: Data from two consecutive national telephone health interview surveys (GEDA 2009 and 2010) including a total of 43,312 adults (≥18 years of age) were analysed. Persons with and without a current diagnosis of asthma were compared with respect to concurrent diagnoses (diabetes mellitus, hypertension, chronic heart failure, depression, osteoarthritis, stroke, coronary heart disease, and cancer). Logistic regression models were applied to assess the strength of the association between asthma and co-morbidities in the total study population and, among persons with asthma, between the number of co-morbidities and unscheduled inpatient (hospital admissions and/or emergency department admissions) or outpatient asthma care in the past 12 months. Results: Overall, 5.3% (95% CI 5.0% to 5.6%) of adults reported current physician-diagnosed asthma. Asthma was significantly associated with most of the conditions considered and 18% of persons with asthma had three or more co-morbidities. Adjusted odds ratios (AOR) of unscheduled asthma care increased with numbers of conditions, with AOR 3.40 (95% CI 1.39 to 8.31) for unscheduled inpatient care and AOR 2.32 (95% CI 1.30 to 4.14) for unscheduled outpatient care comparing those with three or more co-morbidities versus those with none. Conclusions: The magnitude of chronic disease co-morbidity is substantial in asthma, is related to unscheduled asthma care, and implies a significant number of adults with asthma facing complex healthcare needs.

[Prevalence of sensitisation to aeraoallergens and food allergens: results of the German Health Interview and Examination Survey for Adults (DEGS1)].

In view of the increasing prevalence of allergies, up-to-date data on the prevalence of allergic sensitisation are of major interest. In the German Health Interview and Examination Survey for Adults (DEGS1) (2008-2011) blood samples from a population-based sample of 7,025 participants aged 18 to 79 years were analysed for specific IgE antibodies against 50 common single allergens and screened for common aeroallergens (SX1) and grass pollen (GX1). In all, 48.6 % of the participants were sensitised to at least one allergen. Overall, men were more frequently sensitised to at least one allergen than women were. Sensitisations to at least one allergen were more common among younger than older participants and among participants with a higher socio-economic status. In all, 33.6 % of the participants were sensitised to common aeroallergens, 25.5  % to food allergens and 22.6 % to wasp or bee venoms. Compared with the German National Health Interview and Examination Survey 1998 (GNHIES98), the prevalence of sensitisation to common aeroallergens increased from 29.8 to 33.6 %.This increase was statistically significant only in women. The results of DEGS1 still showed a high prevalence of allergic sensitisation. An English full-text version of this article is available at SpringerLink as supplemental.

[Prevalence of allergic diseases in Germany: results of the German Health Interview and Examination Survey for Adults (DEGS1)].

ZusammenfassungIn der ersten Welle der „Studie zur Gesundheit Erwachsener in Deutschland“ (DEGS1) wurden aktuelle und bundesweit repräsentative Daten zum allergischen Krankheitsgeschehen von 7988 18- bis 79-Jährigen mittels computergestützter, ärztlicher Interviews erhoben. Demnach liegt die Lebenszeitprävalenz (LZP) für Asthma bronchiale bei 8,6%, Heuschnupfen bei 14,8%, Neurodermitis und Urtikaria bei jeweils 3,5%, Kontaktekzeme bei 8,1%, Nahrungsmittelallergien bei 4,7% und Insektengiftallergien bei 2,8%. Insgesamt ist bei einem knappen Drittel der Erwachsenen mindestens eine der genannten Allergien jemals ärztlich diagnostiziert worden. Aktuell leiden fast 20% an mindestens einer Allergie. Frauen sind generell häufiger betroffen als Männer und Jüngere häufiger als Ältere. Außerdem sind Allergien in den alten Bundesländern verbreiteter als in den neuen. Ein hoher sozioökonomischer Status und das Leben in Großstädten erhöhen ebenfalls die Krankheitshäufigkeit. Im 10-Jahres-Trend stieg die Asthmaprävalenz um knapp 3%, die Prävalenzen für Urtikaria und Kontaktekzeme sanken, die LZP für Heuschnupfen, Neurodermitis und Nahrungsmittelallergie blieb unverändert. Dadurch ist die Allergieprävalenz insgesamt von 32,7% auf 28,7% rückläufig.AbstractIn the first wave of the “German Health Interview and Examination Survey for Adults” (DEGS1), up-to-date and representative data regarding allergic diseases of 7988 18- to 79-year-old subjects living in Germany were collected using computer-assisted medical interviews. The study identified a lifetime prevalence of 8.6% for asthma, 14.8% for allergic rhinoconjunctivitis, 3.5% each for atopic dermatitis and urticaria, 8.1% for contact eczema, 4.7% for food allergies and 2.8% for insect venom allergies. Overall, nearly one third of adults in Germany have been diagnosed with at least one of the above mentioned allergies during their lifetime by a physician. Currently, nearly 20% suffer from at least one allergic disease. Generally, women reported an allergic disease more frequently than men and younger subjects more frequently than older ones. Additionally, allergies are more common in the former federal states of West Germany than in the former East German federal states. A high socioeconomic status and living in large cities both increase allergy risk. During the last 10 years, asthma prevalence increased about 3%, whereas the prevalence of urticaria and contact eczema declined. The lifetime prevalence of allergic rhinoconjunctivitis, atopic dermatitis and food allergies appeared unchanged. In total, allergy prevalence has declined from 32.7–28.7% over the past decade. An English full-text version of this article is available at SpringerLink as supplemental.

Prevalence of allergic diseases in Germany

ZusammenfassungIn der ersten Welle der „Studie zur Gesundheit Erwachsener in Deutschland“ (DEGS1) wurden aktuelle und bundesweit repräsentative Daten zum allergischen Krankheitsgeschehen von 7988 18- bis 79-Jährigen mittels computergestützter, ärztlicher Interviews erhoben. Demnach liegt die Lebenszeitprävalenz (LZP) für Asthma bronchiale bei 8,6%, Heuschnupfen bei 14,8%, Neurodermitis und Urtikaria bei jeweils 3,5%, Kontaktekzeme bei 8,1%, Nahrungsmittelallergien bei 4,7% und Insektengiftallergien bei 2,8%. Insgesamt ist bei einem knappen Drittel der Erwachsenen mindestens eine der genannten Allergien jemals ärztlich diagnostiziert worden. Aktuell leiden fast 20% an mindestens einer Allergie. Frauen sind generell häufiger betroffen als Männer und Jüngere häufiger als Ältere. Außerdem sind Allergien in den alten Bundesländern verbreiteter als in den neuen. Ein hoher sozioökonomischer Status und das Leben in Großstädten erhöhen ebenfalls die Krankheitshäufigkeit. Im 10-Jahres-Trend stieg die Asthmaprävalenz um knapp 3%, die Prävalenzen für Urtikaria und Kontaktekzeme sanken, die LZP für Heuschnupfen, Neurodermitis und Nahrungsmittelallergie blieb unverändert. Dadurch ist die Allergieprävalenz insgesamt von 32,7% auf 28,7% rückläufig.AbstractIn the first wave of the “German Health Interview and Examination Survey for Adults” (DEGS1), up-to-date and representative data regarding allergic diseases of 7988 18- to 79-year-old subjects living in Germany were collected using computer-assisted medical interviews. The study identified a lifetime prevalence of 8.6% for asthma, 14.8% for allergic rhinoconjunctivitis, 3.5% each for atopic dermatitis and urticaria, 8.1% for contact eczema, 4.7% for food allergies and 2.8% for insect venom allergies. Overall, nearly one third of adults in Germany have been diagnosed with at least one of the above mentioned allergies during their lifetime by a physician. Currently, nearly 20% suffer from at least one allergic disease. Generally, women reported an allergic disease more frequently than men and younger subjects more frequently than older ones. Additionally, allergies are more common in the former federal states of West Germany than in the former East German federal states. A high socioeconomic status and living in large cities both increase allergy risk. During the last 10 years, asthma prevalence increased about 3%, whereas the prevalence of urticaria and contact eczema declined. The lifetime prevalence of allergic rhinoconjunctivitis, atopic dermatitis and food allergies appeared unchanged. In total, allergy prevalence has declined from 32.7–28.7% over the past decade. An English full-text version of this article is available at SpringerLink as supplemental.

Arzneimitteltherapie des Asthma bronchiale

ZusammenfassungDie Lebenszeitprävalenz des Asthma bronchiale beträgt für Erwachsene ca. 5%. Die Wahl der Arzneimitteltherapie richtet sich nach dem Schweregrad der Erkrankung: Sie umfasst die alleinige (bedarfsweise) Anwendung von Bronchodilatatoren bis hin zur zusätzlichen ständigen Anwendung inhalativer und systemischer Glukokortikosteroide. In der vorliegenden Publikation werden die Prävalenz und die medikamentöse Therapie des Asthma bronchiale in einer repräsentativen Stichprobe der 18- bis 79-jährigen Wohnbevölkerung in Deutschland analysiert. Gleichzeitig wird auf die Inanspruchnahme medizinischer Leistungen wie Klinikaufenthalt, notärztliche Behandlung und ambulante ärztliche Behandlung in Abhängigkeit von der Medikation eingegangen. 17,3% der Probanden, die eine ärztliche Diagnose Asthma bejahten, gaben an, ständig kortikoidhaltige Arzneimittel anzuwenden. 19,1% nahmen diese zeitweise, und 61,8% nahmen keine kortikoidhaltigen Arzneimittel ein. Die häufigste Inanspruchnahme medizinischer Leistungen nach einem Asthmaanfall zeigte sich bei Patienten, die angaben, ständig Glukokortikoide anzuwenden. Ältere Asthmatiker nahmen sehr viel häufiger ständig Glukokortikoide ein, nur bei sehr jungen spielte die gelegentliche Einnahme eine überproportionale Rolle. Bei der Erfassung der aktuellen Arzneimittelanwendung (letzte 7 Tage vor der Befragung) mit Hilfe des Arzneimittelsurveys zeigte sich für die Antiasthmatika das folgende Bild: 47,8% der Personen mit Selbstangabe eines Asthma bronchiale in den letzten 4 Wochen gaben die Anwendung inhalativer Adrenergika, 34,8% die Anwendung inhalativer Glukokortikoide, 2,1% die Anwendung systemischer Adrenergika und 19,3% die Anwendung von Theophyllinpräparaten an. Die gemessenen Theophyllinspiegel lagen bei 34,4% unter 5 mg/l, bei 28,1% zwischen 5 und 8 mg/l, bei 35,9% zwischen 8 und 20 mg/l und bei 1,6% der Probanden knapp über 20 mg/l. Die Ergebnisse könnten darauf hinweisen, dass insbesondere junge Asthmatiker unzureichend antiinflammatorisch behandelt werden. Diesen Hinweisen muss weiter nachgegangen, um – bei einer Bestätigung eines Defizits – Maßnahmen zur noch besseren Anlehnung an die existierenden Therapierichtlinien treffen zu können. Insbesondere die gemessenen Theophyllinspiegel der Probanden haben bestätigt, dass ein Drugmonitoring nicht nur ein wichtiger Bestandteil von Gesundheitssurveys ist, sondern auch dazu beitragen könnte, die Sicherheit und Effizienz der Asthmatherapie zu verbessern.AbstractThe lifetime prevalence of bronchial asthma in adults is approximately 5%. Recommended drug therapy of this condition depends largely on its severity and varies from the on demand use of bronchodilators as a single measure up to the additional and sometimes permanent use of inhaled and/or systemic glucocorticoids. In this study, the prevalence and drug therapy of bronchial asthma were analysed in a representative sample of the resident population in Germany aged 18–79 years. We also report about health care utilization, like hospital stay, emergency treatments and use of ambulant medical care, and its associations with asthma medication. Of those study participants who affirmed a medical diagnosis of asthma, 17.3% used corticoid drugs continuously, 19.1% occasionally and 61.8% never. Use of medical services after an asthma attack was reported most often by those who took corticoid drugs regularly. Older people with asthma mostly used glucocorticoids regularly, while in very young patients the occasional use of corticoids was reported more often. When looking at the actual drug use (7 days before the examination) according to the drug usage questionnaire, anti-asthma drugs were mentioned as follows: 47.8% of persons with asthma, diagnosed during the last 4 weeks, used inhaled adrenergic drugs, 34.8% inhaled glucocorticoids, 2.1% systemic adrenergic drugs and 19.3% systemic theophyllines. The measured serum concentrations of theophylline were below 5 mg/l in 34.4%, between 5 and 8 mg/l in 28.1%, between 8 and 20 mg/l in 35.9% and somewhat over 20 mg/l in 1.6%. Our data suggest that especially young asthmatics may not be sufficiently treated with anti-inflammatory therapy, but further studies are needed. If such a deficit can be confirmed, measures for better adherence of therapy to existing guidelines should be considered. Our results, especially on serum concentrations of theophylline, suggest that therapeutic drug monitoring (TDM) of serum samples is not only an important tool in health surveys, but also suitable for increasing the safety and quality of drug treatment in asthmatics.

Asthma management practices in adults – findings from the German Health Update (GEDA) 2010 and the German National Health Interview and Examination Survey (DEGS1) 2008–2011

Abstract Objectives: In Germany, population-wide data on adherence to national asthma management guidelines are lacking, and performance measures (PM) for quality assurance in asthma care are systematically monitored for patients with German national asthma disease management program (DMP) enrollment only. We used national health survey data to assess variation in asthma care PM with respect to patient characteristics and care context, including DMP enrollment. Methods: Among adults 18–79 years with self-reported physician-diagnosed asthma in the past 12 months identified from a recent German National Health Interview Survey (GEDA 2010: N = 1096) and the German National Health interview and Examination Survey 2008–2011 (DEGS1: N = 333), variation in asthma care PM was analyzed using logistic regression analysis. Results: Overall, 38.4% (95% confidence interval: 32.5–44.6%) of adults with asthma were on current inhaled corticosteroid therapy. Regarding non-drug asthma management, low coverage was observed for inhaler technique monitoring (35.2%; 31.2–39.3%) and for provision of an asthma management plan (27.3%; 24.2–30.7%), particularly among those with low education. Specific PM were more complete among persons with than without asthma DMP enrollment (adjusted odds ratios ranging up to 10.19; 5.23–19.86), even if asthma patients were regularly followed in a different care context. Conclusions: Guideline adherence appears to be suboptimal, particularly with respect to PM related to patient counseling. Barriers to the translation of recommendations into practice need to be identified and continuous monitoring of asthma care PM at the population level needs to be established.

Correlations Between Allergic and Infectious Diseases – Results of the Latest German National Health Survey (NHS98) and the German Health Interview and Examination Survey for Children and Adolescents (KiGGS)

In the literature, according to the hygiene hypothesis, infections should be expected to correlate with fewer al- lergies. However, several studies clearly show that infections - especially infections of the upper respiratory tract - and surrogate parameters such as the use of antibiotics or paracetamol correlate with a higher rate of allergies. This article re- views the literature (50 articles are analyzed) on possible connections between infections and allergies and offers some possible explanations. Original data from population-based health interviews and examination surveys of adults, children and adolescents are added. These data show a clear correlation between most infections and an enhanced allergy rate. Nevertheless, although the correlastions obtained seem intriguing, it has to be kept in mind, that no clear direction of the correlations can be stated since the database does not allow for such interpretation. So, the data do not necessarily add to the picture of the hygiene hypothesis, as the infections could have followed the allergies. The probability of suffering from an allergy rises with the number of infections (or vice versa) a person has had (e.g. the risk for adults of developing asthma is enhanced to 1.3 CI-95% 1.2-1.4 with enhanced numbers of former infections with pertussis, chickenpox, scarlet fever, dysentery or typhoid/paratyphoid). This applies especially to pertussis (e.g. 15.8% CI-95% 13.6-18.3% of children with hayfever had pertussis versus 7.6% CI-95% 6.9-8.3% of the healthy children) and chickenpox infections (e.g. 84.7% CI-95% 82.7-86.6% of children with hayfever had chickenpox versus 66.8% CI-95% 65.8-67.8% of the healthy children), both of which are preventable by vaccination.

Drug therapy of asthma. Results of the 1998 German National Health Interview and Examination Survey

ZusammenfassungDie Lebenszeitprävalenz des Asthma bronchiale beträgt für Erwachsene ca. 5%. Die Wahl der Arzneimitteltherapie richtet sich nach dem Schweregrad der Erkrankung: Sie umfasst die alleinige (bedarfsweise) Anwendung von Bronchodilatatoren bis hin zur zusätzlichen ständigen Anwendung inhalativer und systemischer Glukokortikosteroide. In der vorliegenden Publikation werden die Prävalenz und die medikamentöse Therapie des Asthma bronchiale in einer repräsentativen Stichprobe der 18- bis 79-jährigen Wohnbevölkerung in Deutschland analysiert. Gleichzeitig wird auf die Inanspruchnahme medizinischer Leistungen wie Klinikaufenthalt, notärztliche Behandlung und ambulante ärztliche Behandlung in Abhängigkeit von der Medikation eingegangen. 17,3% der Probanden, die eine ärztliche Diagnose Asthma bejahten, gaben an, ständig kortikoidhaltige Arzneimittel anzuwenden. 19,1% nahmen diese zeitweise, und 61,8% nahmen keine kortikoidhaltigen Arzneimittel ein. Die häufigste Inanspruchnahme medizinischer Leistungen nach einem Asthmaanfall zeigte sich bei Patienten, die angaben, ständig Glukokortikoide anzuwenden. Ältere Asthmatiker nahmen sehr viel häufiger ständig Glukokortikoide ein, nur bei sehr jungen spielte die gelegentliche Einnahme eine überproportionale Rolle. Bei der Erfassung der aktuellen Arzneimittelanwendung (letzte 7 Tage vor der Befragung) mit Hilfe des Arzneimittelsurveys zeigte sich für die Antiasthmatika das folgende Bild: 47,8% der Personen mit Selbstangabe eines Asthma bronchiale in den letzten 4 Wochen gaben die Anwendung inhalativer Adrenergika, 34,8% die Anwendung inhalativer Glukokortikoide, 2,1% die Anwendung systemischer Adrenergika und 19,3% die Anwendung von Theophyllinpräparaten an. Die gemessenen Theophyllinspiegel lagen bei 34,4% unter 5 mg/l, bei 28,1% zwischen 5 und 8 mg/l, bei 35,9% zwischen 8 und 20 mg/l und bei 1,6% der Probanden knapp über 20 mg/l. Die Ergebnisse könnten darauf hinweisen, dass insbesondere junge Asthmatiker unzureichend antiinflammatorisch behandelt werden. Diesen Hinweisen muss weiter nachgegangen, um – bei einer Bestätigung eines Defizits – Maßnahmen zur noch besseren Anlehnung an die existierenden Therapierichtlinien treffen zu können. Insbesondere die gemessenen Theophyllinspiegel der Probanden haben bestätigt, dass ein Drugmonitoring nicht nur ein wichtiger Bestandteil von Gesundheitssurveys ist, sondern auch dazu beitragen könnte, die Sicherheit und Effizienz der Asthmatherapie zu verbessern.AbstractThe lifetime prevalence of bronchial asthma in adults is approximately 5%. Recommended drug therapy of this condition depends largely on its severity and varies from the on demand use of bronchodilators as a single measure up to the additional and sometimes permanent use of inhaled and/or systemic glucocorticoids. In this study, the prevalence and drug therapy of bronchial asthma were analysed in a representative sample of the resident population in Germany aged 18–79 years. We also report about health care utilization, like hospital stay, emergency treatments and use of ambulant medical care, and its associations with asthma medication. Of those study participants who affirmed a medical diagnosis of asthma, 17.3% used corticoid drugs continuously, 19.1% occasionally and 61.8% never. Use of medical services after an asthma attack was reported most often by those who took corticoid drugs regularly. Older people with asthma mostly used glucocorticoids regularly, while in very young patients the occasional use of corticoids was reported more often. When looking at the actual drug use (7 days before the examination) according to the drug usage questionnaire, anti-asthma drugs were mentioned as follows: 47.8% of persons with asthma, diagnosed during the last 4 weeks, used inhaled adrenergic drugs, 34.8% inhaled glucocorticoids, 2.1% systemic adrenergic drugs and 19.3% systemic theophyllines. The measured serum concentrations of theophylline were below 5 mg/l in 34.4%, between 5 and 8 mg/l in 28.1%, between 8 and 20 mg/l in 35.9% and somewhat over 20 mg/l in 1.6%. Our data suggest that especially young asthmatics may not be sufficiently treated with anti-inflammatory therapy, but further studies are needed. If such a deficit can be confirmed, measures for better adherence of therapy to existing guidelines should be considered. Our results, especially on serum concentrations of theophylline, suggest that therapeutic drug monitoring (TDM) of serum samples is not only an important tool in health surveys, but also suitable for increasing the safety and quality of drug treatment in asthmatics.