The impact of dysfunctional breathing on the assessment of asthma control

TY - JOUR

T1 - The impact of dysfunctional breathing on the assessment of asthma control

AU - Veidal, Sandra

AU - Jeppegaard, Maria

AU - Sverrild, Asger

AU - Backer, Vibeke

AU - Porsbjerg, Celeste

N1 - Copyright © 2016 Elsevier Ltd. All rights reserved.

PY - 2017/2/1

Y1 - 2017/2/1

N2 - Background and objective Dysfunctional breathing (DB) is a respiratory disorder, which involves a pattern of breathing too deeply, too superficially and/or too rapidly. In asthma patients, DB may lead to an overestimation of the severity of asthma symptoms, and hence potentially to overtreatment. However, it is not known to which degree DB may affect estimates of asthma control, in a specialist clinical setting. Methods The MAPOut-study examined all patients referred consecutively over a 12-months period for specialist assessment of asthma at the Respiratory Outpatient Clinic at Bispebjerg Hospital in Copenhagen. All patients were examined with the Nijmegen questionnaire with a DB defined as a score ≥23 and the ACQ questionnaire. Linear regression analysis of predictors of ACQ score was performed. Asthma was defined as asthma symptoms and a positive asthma test. Results Of the 256 patients referred to the lung clinic, data on both the Nijmegen questionnaire and ACQ score was obtained in 127 patients, who were included in the present analysis. Median (range) age: 30 (15–63) years, and 76 (59.8%) were females. DB was found in 31 (24.4%). Asthmatic patients with co-existing DB had a poorer asthma control compared to asthmatics without DB (Median (range) ACQ score: 2.40 (0.20–4.60) vs 1.20 (0.00–4.40); p < 0.001.). A regression analysis showed that the effect of DB on asthma control was independent of airway hyperresponsiveness or airway inflammation in patients with DB. Conclusion Dysfunctional breathing is common among asthma patients in a specialist setting, and results in a clinically significant underestimation of asthma control, which may potentially lead to overtreatment.

AB - Background and objective Dysfunctional breathing (DB) is a respiratory disorder, which involves a pattern of breathing too deeply, too superficially and/or too rapidly. In asthma patients, DB may lead to an overestimation of the severity of asthma symptoms, and hence potentially to overtreatment. However, it is not known to which degree DB may affect estimates of asthma control, in a specialist clinical setting. Methods The MAPOut-study examined all patients referred consecutively over a 12-months period for specialist assessment of asthma at the Respiratory Outpatient Clinic at Bispebjerg Hospital in Copenhagen. All patients were examined with the Nijmegen questionnaire with a DB defined as a score ≥23 and the ACQ questionnaire. Linear regression analysis of predictors of ACQ score was performed. Asthma was defined as asthma symptoms and a positive asthma test. Results Of the 256 patients referred to the lung clinic, data on both the Nijmegen questionnaire and ACQ score was obtained in 127 patients, who were included in the present analysis. Median (range) age: 30 (15–63) years, and 76 (59.8%) were females. DB was found in 31 (24.4%). Asthmatic patients with co-existing DB had a poorer asthma control compared to asthmatics without DB (Median (range) ACQ score: 2.40 (0.20–4.60) vs 1.20 (0.00–4.40); p < 0.001.). A regression analysis showed that the effect of DB on asthma control was independent of airway hyperresponsiveness or airway inflammation in patients with DB. Conclusion Dysfunctional breathing is common among asthma patients in a specialist setting, and results in a clinically significant underestimation of asthma control, which may potentially lead to overtreatment.

KW - Adolescent

KW - Adult

KW - Asthma/complications

KW - Bronchial Provocation Tests/methods

KW - Cross-Sectional Studies

KW - Female

KW - Forced Expiratory Volume/physiology

KW - Glucocorticoids/therapeutic use

KW - Humans

KW - Hyperventilation/complications

KW - Male

KW - Middle Aged

KW - Severity of Illness Index

KW - Spirometry/methods

KW - Surveys and Questionnaires

KW - Treatment Outcome

KW - Vital Capacity/physiology

KW - Young Adult

U2 - 10.1016/j.rmed.2016.12.008

DO - 10.1016/j.rmed.2016.12.008

M3 - Journal article

C2 - 28137495

SN - 0954-6111

VL - 123

SP - 42

EP - 47

JO - Respiratory Medicine

JF - Respiratory Medicine

ER -