Presentation: Perceptions and practices of severe asthma and asthma-COPD overlap syndrome among specialists: A questionnaire survey ( World Allergy Congress)

Wednesday, 14 October 2015

Hall D1 Foyer (Floor 3) (Coex Convention Center)

Sang-Heon Kim, MD , Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea

Ji-Yong Moon, MD , Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea

Jae-Hyun Lee, MD, PhD , Division of Allergy and Immunology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea

Ga Young Ban, MD , Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, South Korea

Sujeong Kim, MD , Division of Allergy and Clinical Immunology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea

Mi-Ae Kim, MD , Allergy and Clinical Immunology, Bundang Medical Center, CHA University, Seongnam, South Korea

Joo-Hee Kim, MD , Department of Internal Medicine, Hallym University College of Medicine, Anyang, South Korea

Min-Hye Kim, MD , Internal Medicine, Ewha Womans University, School of Medicine, Seoul, South Korea

Chan-Sun Park, MD , Department of Internal Medicine, Inje University College of Medicine, Busan, South Korea

Hyouk-Soo Kwon, MD, PhD , Division of Allergy and Clinical Immunology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea

Jae-Woo Kwon, MD , Division of Allergy and Clinical Immunology, Department of Internal Medicine, Kangwon National University College of Medicine, Chuncheon, South Korea

Jae Woo Jung , Internal Medicine, Chung-Ang University Hospital, Seoul, South Korea

Hye-Ryun Kang, MD, PhD , Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea

Jong-Sook Park, MD , Division of Allergy and Respiratory Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, South Korea

Tae-Bum Kim, MD, PhD , Division of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea

Heung Woo Park, MD, PhD , Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea

You Sook Cho, MD, PhD , Division of Allergy and Clinical Immunology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea

Kwang-Ha Yoo, MD , Department of Internal Medicine, Konkuk University College of Medicine, Seoul, South Korea

Yeon-Mok Oh, MD , Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, South Korea

An-Soo Jang , Division of Allergy and Respiratory Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, South Korea

Byung-Jae Lee, MD, PhD , Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

Sang-Heon Cho, MD, PhD , Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea

Hae-Sim Park, MD, PhD , Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, South Korea

Choon-Sik Park, MD., PhD. , Department of Internal Medicine, Soonchunhyang University Hospital, Bucheon, South Korea

Ho Joo Yoon, MD , Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea

Background: Severe asthma and asthma-COPD overlap syndrome (ACOS) are gaining more and more attention since these diseases are hard to control and often associated with poor clinical outcomes. However, the diagnosis and managements varies depending on clinicians because there is no agreement on the definition and therapeutic approaches in these diseases. To evaluate the current understandings and clinical practices on severe asthma and COPD among asthma and COPD specialists in Korea, We designed a questionnaire survey using e-mail and web-based platform.

Methods: Subjects were selected based on their clinical specialty from the members of the Korean Academy of Asthma, Allergy and Clinical Immunology and the some study groups of the Korean Academy of Tuberculosis and Respiratory Diseases. Of 432 subjects who received e-mail, 103 subjects (58 allergists and 37 pulmonologists) responded and submitted their answers by online administration.

Results: Regarding severe asthma features, the most common type was asthma aggravation by stepping down treatment (21.8%) followed by frequent exacerbation (20.6%), uncontrolled asthma despite higher treatment step (13.4%) and severe exacerbation (12.6%). The subjects responded that the proportion of severe asthma was 13.8% of the asthma patients in their clinic and there was no difference between allergists and pulmonologists. ACOS was estimated to be 20.7% of asthma, 37.9% of severe asthma and 29.5% of COPD, while allergists gave more proportions of ACOS among COPD than pulmonologists (35.4% vs. 22.6%). Regarding the diagnostic criteria for ACOS among asthma patients, smoking history (84.5%), persistently low FEV₁ (80.6%) and low FEV₁ variation (71.8%) were most frequently chosen for major criteria. Contrarily, the highly selected major criteria for ACOS among COPD patients were high FEV₁ variation (85.4%), positive bronchodilator response (77.7%) and personal history of allergy (75.7%).

Conclusions: The asthma and COPD specialists had diverse view on the perceptions and clinical practices on severe asthma and ACOS. These heterogeneity needs to be considered in developing guidelines and health policies of severe asthma and ACOS.

1009 Perceptions and practices of severe asthma and asthma-COPD overlap syndrome among specialists: A questionnaire survey