Dataset Information

Asthma rehabilitation at high vs. low altitude: randomized parallel-group trial.

ABSTRACT: BACKGROUND:To investigate the effect of asthma rehabilitation at high altitude (3100?m, HA) compared to low altitude (760?m, LA). METHODS:For this randomized parallel-group trial insufficiently controlled asthmatics (Asthma Control Questionnaire (ACQ) >?0.75) were randomly assigned to 3-week in-hospital rehabilitation comprising education, physical-&breathing-exercises at LA or HA. Co-primary outcomes assessed at 760?m were between group changes in peak expiratory flow (PEF)-variability, and ACQ) from baseline to end-rehabilitation and 3?months thereafter. RESULTS:50 asthmatics were randomized [median (quartiles) LA: ACQ 2.7(1.7;3.2), PEF-variability 19%(14;33); HA: ACQ 2.0(1.6;3.0), PEF-variability 17%(12;32)]. The LA-group improved PEF-variability by median(95%CI) -7%(-?14 to 0, p?=?0.033), ACQ -?1.4(-?2.2 to -?0.9, p?

SUBMITTER: Saxer S

PROVIDER: S-EPMC6657156 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature

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Asthma rehabilitation at high vs. low altitude: randomized parallel-group trial.

Saxer Stéphanie S Schneider Simon R SR Appenzeller Paula P Bader Patrick R PR Lichtblau Mona M Furian Michael M Sheraliev Ulan U Estebesova Bermet B Emilov Berik B Sooronbaev Talant T Bloch Konrad E KE Ulrich Silvia S

BMC pulmonary medicine 20190724 1

<h4>Background</h4>To investigate the effect of asthma rehabilitation at high altitude (3100 m, HA) compared to low altitude (760 m, LA).<h4>Methods</h4>For this randomized parallel-group trial insufficiently controlled asthmatics (Asthma Control Questionnaire (ACQ) > 0.75) were randomly assigned to 3-week in-hospital rehabilitation comprising education, physical-&breathing-exercises at LA or HA. Co-primary outcomes assessed at 760 m were between group changes in peak expiratory flow (PEF)-varia ...[more]

PMID: 31340793

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Project description:BackgroundIn patients with severe asthma, high-altitude climate treatment has been shown to improve asthma control. However, asthma symptoms and limitations may increase after finishing inpatient rehabilitation programs and returning to sea level.ObjectiveWe assessed the effectiveness of a patient-tailored, internet-based, self-management strategy in addition to usual care after finishing high-altitude climate treatment.MethodsWe performed a randomized controlled trial with a 1-year follow-up in patients from a high-altitude asthma center in Davos, Switzerland. At the end of a 12-week multidisciplinary rehabilitation program, 62 adults with asthma were randomized to receive either internet-based self-management support in addition to usual care (n=33) or usual care only after discharge (n=29). The endpoints were changes in asthma-related quality of life according to the Asthma Quality of Life Questionnaire (AQLQ) (a higher score is better) and asthma control according to the Asthma Control Questionnaire (ACQ) (a lower score is better), with a minimally important difference of 0.5 points for both.ResultsAsthma-related quality of life and asthma control declined over time in the usual care strategy group, whereas there was a slower decline in the internet-based strategy group. For both endpoints, mixed-model analysis showed a significant positive effect in favor of internet-based self-management during follow-up (mean AQLQ score difference 0.39, 95% CI 0.092-0.69; P=.01 and ACQ score difference -0.50, 95% CI -0.86 to -0.15; P=.006), which was prominent among patients with uncontrolled asthma at discharge (AQLQ score difference 0.59, 95% CI 0.19-0.99; P=.003 and ACQ score difference -0.73, 95% CI -1.18 to -0.28; P=.002).ConclusionsInternet-based self-management support was associated with a smaller decline in quality of life and asthma control as compared with usual care, especially in patients with lower asthma control, after completion of high-altitude climate treatment. Internet-based self-management support in adults with severe asthma seems feasible and effective to maintain quality of life and asthma control.Trial registrationThe trial is registered in the Netherlands Trial Register (NTR1995).

Dataset Information

Asthma rehabilitation at high vs. low altitude: randomized parallel-group trial.

Publications

Asthma rehabilitation at high vs. low altitude: randomized parallel-group trial.

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