Real Impact of Lockdown on Asthma Treatment – EAACI Survey Results
Restrictions associated with the COVID-19 pandemic have had a significant impact on the treatment of chronic diseases such as asthma. A study published in the journal Allergy focused on evaluating treatment approaches for adult and pediatric patients with asthma during the coronavirus pandemic lockdowns.
Survey
In July 2020, the European Academy of Allergy and Clinical Immunology (EAACI) sent out a survey to its members and members of affiliated professional societies, addressing patient treatment practices and office management during the coronavirus preventive measures.
The survey was completed by 339 healthcare workers from 52 countries. In most countries, national guidelines for asthma treatment during the pandemic existed, and 74% of respondents followed them.
Impact of the Pandemic on Patient Examination
Only in 10% of cases were there no restrictions on in-person office visits. 79% of follow-up visits were replaced by telephone consultations, and 49% of newly referred patients could visit the clinics in person.
Use of Pulmonary Function Tests
Pulmonary function testing using spirometry poses a potential danger due to the creation of aerosols, which can be infectious. During the lockdown, 62% of respondents did not perform spirometry on adult patients, 76% stopped performing oscillometry, 66% did not use the bronchodilation test, 76% did not measure exhaled NO, and 87% discontinued methacholine provocation. The results were similar for doctors treating pediatric patients.
Impacts on Diagnosis and Treatment
73% of respondents made the initial asthma diagnosis and prescribed inhalation therapy based solely on clinical parameters. Only 19% of participants completed the full recommended asthma diagnosis procedure.
For patients reporting clinical worsening, pulmonary function testing was used in only 29% of cases. More than two-thirds of respondents adjusted existing treatment based solely on current symptoms and patient history.
Conclusion
The survey results suggest that available resources should be allocated primarily to ensure pulmonary function testing during initial diagnosis. Subsequent follow-ups could then be conducted through virtual meetings.
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Source: Eguiluz-Gracia I., van den Berge M., Boccabella C. et al. Real-life impact of COVID-19 pandemic lockdown on the management of pediatric and adult asthma: a survey by the EAACI Asthma Section. Allergy 2021; 76 (9): 2776−2784, doi: 10.1111/all.14831.
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