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Asthma-COPD overlap: a Portuguese survey

2018-05-01Journal article Open access
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dc.contributor.authorPadrão, E.
dc.contributor.authorAraújo, D.
dc.contributor.authorBom, A. Todo
dc.contributor.authorCordeiro, C. Robalo
dc.contributor.authorSousa, J. Correia de
dc.contributor.authorCardoso, J.
dc.contributor.authorMorais-Almeida, M.
dc.contributor.authorCosta, R.
dc.contributor.authorPavão, F.
dc.contributor.authorLeite, R. B.
dc.contributor.authorMarques, A.
dc.date.accessioned2021-04-16T09:06:24Z
dc.date.available2021-04-16T09:06:24Z
dc.date.issued2018-05-01
dc.description.abstractIntroduction: The overlap between asthma and chronic obstructive pulmonary disease (COPD) (ACO) has been discussed for many years but clinical recommendations for this entity have been diverse. This study is intended to reach a consensus on diagnosis, treatment and patient orientation for ACO, within the Portuguese medical community. Methods: This study was conducted by a multidisciplinary panel of experts from three distinct medical specialties (Pulmonology, Family Medicine and Immunoallergology). This panel selected a total of 190 clinicians, based on their expertise in obstructive airway diseases, to participate in a Delphi structured survey with three rounds of questionnaires. These results were ultimately discussed, in a meeting with the panel of experts and some of the study participants, and consensus was reached in terms of classification criteria, treatment and orientation of ACO patients. Results: The majority of clinicians (87.2%) considered relevant the definition of an overlap entity between asthma and COPD. A consensus was achieved on the diagnosis of ACO – presence of simultaneous clinical characteristics of asthma and COPD together with a fixed airflow obstruction (FEV1/FVC < 0.7) associated with 2 major criteria (previous history of asthma; presence of a previous history of smoking exposure and/or exposure to biomass combustion; positive bronchodilation test (increase in FEV1 of at least 200 mL and 12%) on more than 1 occasion) plus 1 minor criteria (history of atopy; age ≥40 years; peripheral eosinophilia (>300 eosinophils/μL or >5% of leukocytes); elevation of specific IgEs or positive skin tests for common allergens). A combination of inhaled corticosteroid (ICS) with long-acting beta2-agonist (LABA) or long-acting muscarinic antagonist (LAMA) was considered as first line pharmacological treatment. Triple therapy with ICS plus LABA and LAMA should be used in more severe or symptomatic cases. Non-pharmacological treatment, similar to what is recommended for asthma and COPD, was also considered highly important. A hospital referral of ACO patients should be made in symptomatic or severe cases or when there is a lack of diagnostic resources. Conclusions: This study highlights the relevance of defining ACO, within the Portuguese medical community, and establishes diagnostic criteria that are important for future interventional studies. Recommendations on treatment and patient's orientation were also achieved.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.doi10.1016/j.rppnen.2017.11.009pt_PT
dc.identifier.eid85049977181
dc.identifier.issn2531-0429
dc.identifier.pmid29338973
dc.identifier.urihttp://hdl.handle.net/10400.14/32653
dc.identifier.wos000433492600007
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/pt_PT
dc.subjectAsthmapt_PT
dc.subjectCOPDpt_PT
dc.subjectDefinitionpt_PT
dc.subjectDelphi surveypt_PT
dc.subjectDiagnosispt_PT
dc.subjectManagementpt_PT
dc.subjectOverlappt_PT
dc.titleAsthma-COPD overlap: a Portuguese surveypt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage181pt_PT
oaire.citation.issue3pt_PT
oaire.citation.startPage174pt_PT
oaire.citation.titlePulmonologypt_PT
oaire.citation.volume24pt_PT
person.familyNameTodo-Bom
person.familyNameRobalo Cordeiro
person.familyNameCorreia de Sousa
person.familyNameMachado da Costa
person.familyNameMarques
person.givenNameAna
person.givenNameCarlos Manuel da Silva
person.givenNameJaime
person.givenNameRui Manuel
person.givenNameAlda Sofia Pires
person.identifier1045180
person.identifier.ciencia-id3215-66B6-1364
person.identifier.ciencia-idF51F-6FB4-BA99
person.identifier.ciencia-id9414-18D1-7C76
person.identifier.ciencia-id861C-574D-2760
person.identifier.ciencia-idDE15-EFBA-4856
person.identifier.orcid0000-0002-1850-6689
person.identifier.orcid0000-0002-8264-3856
person.identifier.orcid0000-0001-6459-7908
person.identifier.orcid0000-0003-2488-0914
person.identifier.orcid0000-0003-4980-6200
person.identifier.ridI-4864-2012
person.identifier.ridH-5607-2015
person.identifier.ridF-9414-2014
person.identifier.ridK-3150-2013
person.identifier.scopus-author-id15847298500
person.identifier.scopus-author-id14064102000
person.identifier.scopus-author-id7102813038
person.identifier.scopus-author-id35317128100
person.identifier.scopus-author-id27567793100
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
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