help button home button
AJRCCM
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Online Data Supplement
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Fuhlbrigge, A. L.
Right arrow Articles by Weiss, S. T.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Fuhlbrigge, A. L.
Right arrow Articles by Weiss, S. T.
American Journal of Respiratory and Critical Care Medicine Vol 166. pp. 1044-1049, (2002)
© 2002 American Thoracic Society

Articles

The Burden of Asthma in the United States

Level and Distribution Are Dependent on Interpretation of the National Asthma Education and Prevention Program Guidelines

Anne L. Fuhlbrigge, Robert J. Adams, Theresa W. Guilbert, Evie Grant, Paula Lozano, Susan L. Janson, Fernando Martinez, Kevin B. Weiss and Scott T. Weiss

Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Department of Medicine, The University of Adelaide, The Queen Elizabeth Hospital Campus, Woodville, South Australia, Australia; University of Arizona, Respiratory Sciences Center, Tucson, Arizona; Center for Healthcare Studies, Northwestern University, Chicago, Illinois; Center for Health Studies, Group Health Cooperative of Puget Sound, and Department of Pediatrics, University of Washington, Seattle, Washington; and Departments of Community Health Systems and Medicine, University of California, San Francisco, California

Correspondence and requests for reprints should be addressed to Anne Fuhlbrigge, M.D., M.S., Channing Laboratory, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA 02115. E-mail: anne.fuhlbrigge{at}channing.harvard.edu

ABSTRACT

Asthma imposes a growing burden on society in terms of morbidity, quality of life, and healthcare costs. Although federally sponsored national surveys provide estimates of asthma prevalence, these surveys are not designed to characterize the burden of asthma by self-reported disease activity. We sought to characterize asthma burden in the United States. This study was based on a cross-sectional random-digit-dial household telephone survey designed to identify adult patients and parents of children with current asthma. Global asthma burden was comprised of three components: short-term symptom burden (4-week recall), long-term symptom burden (past year), and functional impact (activity limitation). Using this construct, only 10.7% of individuals were classified as having a global asthma burden consistent with mild intermittent disease, and 77.3% had moderate to severe persistent disease. These results suggest that a majority of the United States population with asthma experiences persistent rather than intermittent asthma burden. In addition, the discordance in type and distribution of asthma symptoms reported by individual subjects suggests that the exact estimate of the burden of asthma is related to how the National Asthma Education and Prevention Program classification is operationalized. Inquiry into recent day or nighttime symptoms alone underestimates the burden of asthma and may lead to inadequate treatment of asthma based on national guideline recommendations.

Key Words: asthma • epidemiology • burden of illness • severity of illness index




This article has been cited by other articles:


Home page
 Mayo Clin Proc.Home page
M. E. Wechsler
Managing Asthma in Primary Care: Putting New Guideline Recommendations Into Context
Mayo Clin. Proc., August 1, 2009; 84(8): 707 - 717.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
H. K. Reddel, D. R. Taylor, E. D. Bateman, L.-P. Boulet, H. A. Boushey, W. W. Busse, T. B. Casale, P. Chanez, P. L. Enright, P. G. Gibson, et al.
An Official American Thoracic Society/European Respiratory Society Statement: Asthma Control and Exacerbations: Standardizing Endpoints for Clinical Asthma Trials and Clinical Practice
Am. J. Respir. Crit. Care Med., July 1, 2009; 180(1): 59 - 99.
[Abstract] [Full Text] [PDF]

Home page
 Ann Fam MedHome page
D. L. Hahn
Importance of Evidence Grading for Guideline Implementation: The Example of Asthma
Ann. Fam. Med, July 1, 2009; 7(4): 364 - 369.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
S. R. Daniels, M. S. Jacobson, B. W. McCrindle, R. H. Eckel, and B. M. Sanner
American Heart Association Childhood Obesity Research Summit: Executive Summary
Circulation, April 21, 2009; 119(15): 2114 - 2123.
[Full Text] [PDF]

Home page
 CirculationHome page
S. R. Daniels, M. S. Jacobson, B. W. McCrindle, R. H. Eckel, and B. M. Sanner
American Heart Association Childhood Obesity Research Summit Report
Circulation, April 21, 2009; 119(15): e489 - e517.
[Full Text] [PDF]

Home page
 ChestHome page
X. Zhou, F.-m. Ding, J.-t. Lin, and K.-s. Yin
Validity of Asthma Control Test for Asthma Control Assessment in Chinese Primary Care Settings
Chest, April 1, 2009; 135(4): 904 - 910.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
D. R. Taylor, E. D. Bateman, L-P. Boulet, H. A. Boushey, W. W. Busse, T. B. Casale, P. Chanez, P. L. Enright, P. G. Gibson, J. C. de Jongste, et al.
A new perspective on concepts of asthma severity and control
Eur. Respir. J., September 1, 2008; 32(3): 545 - 554.
[Abstract] [Full Text] [PDF]

Home page
 Ther Adv Respir DisHome page
E. Zervas, E. Oikonomidou, E. Kainis, M. Kokkala, K. Petroheilou, and M. Gaga
Review: Control of asthma
Therapeutic Advances in Respiratory Disease, June 1, 2008; 2(3): 141 - 148.
[Abstract] [PDF]

Home page
 ERRHome page
A. P. Greening, D. Stempel, E. D. Bateman, and J. C. Virchow
Managing asthma patients: which outcomes matter?
Eur. Respir. Rev., June 1, 2008; 17(108): 53 - 61.
[Abstract] [Full Text] [PDF]

Home page
 Am J Health Syst PharmHome page
C. A. Camargo Jr., S. Ramachandran, K. L. Ryskina, B. E. Lewis, and A. P. Legorreta
Association between common asthma therapies and recurrent asthma exacerbations in children enrolled in a state Medicaid plan
Am. J. Health Syst. Pharm., May 15, 2007; 64(10): 1054 - 1061.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
A. M. Butz, M. Tsoukleris, M. Donithan, V. D. Hsu, K. Mudd, I. H. Zuckerman, and M. E. Bollinger
Patterns of Inhaled Antiinflammatory Medication Use in Young Underserved Children With Asthma
Pediatrics, December 1, 2006; 118(6): 2504 - 2513.
[Abstract] [Full Text] [PDF]

Home page
 ThoraxHome page
C N A Palmer, B J Lipworth, S Lee, T Ismail, D F Macgregor, and S Mukhopadhyay
Arginine-16 {beta}2 adrenoceptor genotype predisposes to exacerbations in young asthmatics taking regular salmeterol
Thorax, November 1, 2006; 61(11): 940 - 944.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
L. P. Richardson, P. Lozano, J. Russo, E. McCauley, T. Bush, and W. Katon
Asthma Symptom Burden: Relationship to Asthma Severity and Anxiety and Depression Symptoms
Pediatrics, September 1, 2006; 118(3): 1042 - 1051.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
A. L. Fuhlbrigge, T. Guilbert, J. Spahn, D. Peden, and K. Davis
The Influence of Variation in Type and Pattern of Symptoms on Assessment in Pediatric Asthma
Pediatrics, August 1, 2006; 118(2): 619 - 625.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
M. Schatz, R. S. Zeiger, W. M. Vollmer, D. Mosen, G. Mendoza, A. J. Apter, T. B. Stibolt, A. Leong, M. S. Johnson, and E. F. Cook
The Controller-to-Total Asthma Medication Ratio Is Associated With Patient-Centered As Well As Utilization Outcomes.
Chest, July 1, 2006; 130(1): 43 - 50.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
L. M. Graham
Classifying Asthma
Chest, July 1, 2006; 130(1_suppl): 13S - 20S.
[Abstract] [Full Text] [PDF]

Home page
 ERRHome page
A. E. Williams, A. C. Lloyd, L. Watson, and K. F. Rabe
Cost of scheduled and unscheduled asthma management in seven European Union countries
Eur. Respir. Rev., June 1, 2006; 15(98): 4 - 9.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
S. P. Galant, T. Morphew, S. Amaro, and O. Liao
Current Asthma Guidelines May Not Identify Young Children Who Have Experienced Significant Morbidity
Pediatrics, April 1, 2006; 117(4): 1038 - 1045.
[Abstract] [Full Text] [PDF]

Home page
 NEJMHome page
M. L. Mintz, G. T. O'Connor, and F. D. Martinez
Safety of long-acting beta-agonists.
N. Engl. J. Med., March 16, 2006; 354(11): 1206 - 1208.
[Full Text] [PDF]

Home page
 ChestHome page
R. J. Adams, D. H. Wilson, A. W. Taylor, A. Daly, E. Tursan d'Espaignet, E. Dal Grande, and R. E. Ruffin
Coexistent chronic conditions and asthma quality of life: a population-based study.
Chest, February 1, 2006; 129(2): 285 - 291.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
M. Schatz, R. Nakahiro, W. Crawford, G. Mendoza, D. Mosen, and T. B. Stibolt
Asthma Quality-of-Care Markers Using Administrative Data
Chest, October 1, 2005; 128(4): 1968 - 1973.
[Abstract] [Full Text] [PDF]

Home page
 Ann Fam MedHome page
T. Ostbye, K. S. H. Yarnall, K. M. Krause, K. I. Pollak, M. Gradison, and J. L. Michener
Is There Time for Management of Patients With Chronic Diseases in Primary Care?
Ann. Fam. Med, May 1, 2005; 3(3): 209 - 214.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
P. Robichaud, A. Laberge, M.-F. Allen, H. Boutin, C. Rossi, P. Lajoie, and L.-P. Boulet
Evaluation of a Program Aimed at Increasing Referrals for Asthma Education of Patients Consulting at the Emergency Department for Acute Asthma
Chest, November 1, 2004; 126(5): 1495 - 1501.
[Abstract] [Full Text] [PDF]

Home page
 J. Virol.Home page
M. B. Elliott, K. S. Pryharski, Q. Yu, L. A. Boutilier, N. Campeol, K. Melville, T. S. Laughlin, C. K. Gupta, R. A. Lerch, V. B. Randolph, et al.
Characterization of Recombinant Respiratory Syncytial Viruses with the Region Responsible for Type 2 T-Cell Responses and Pulmonary Eosinophilia Deleted from the Attachment (G) Protein
J. Virol., August 15, 2004; 78(16): 8446 - 8454.
[Abstract] [Full Text] [PDF]

Home page
 Clin Med ResHome page
G. L. Colice
Categorizing Asthma Severity: An Overview of National Guidelines
Clin. Med. Res., August 1, 2004; 2(3): 155 - 163.
[Abstract] [Full Text] [PDF]

Home page
 J Am Board Fam MedHome page
D. L. Hahn and M. B. Plane
Feasibility of a Practical Clinical Trial for Asthma Conducted in Primary Care
J Am Board Fam Med, May 1, 2004; 17(3): 190 - 195.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
R. N. Rubin, L. Navon, and P. A. Cassano
Relationship of Serum Antioxidants to Asthma Prevalence in Youth
Am. J. Respir. Crit. Care Med., February 1, 2004; 169(3): 393 - 398.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
G. L. Colice
The Seduction of Asthma Severity Categorization
Chest, December 1, 2003; 124(6): 2054 - 2056.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
M. J. Tobin
Asthma, Airway Biology, and Nasal Disorders in AJRCCM 2002
Am. J. Respir. Crit. Care Med., February 1, 2003; 167(3): 319 - 332.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Proc. Am. Thorac. Soc. Am. J. Respir. Cell Mol. Biol.
Copyright © 2002 American Thoracic Society 		  Work-Life