Symptom- and fraction of exhaled nitric oxide–driven strategies for asthma control: A cluster-randomized trial in primary care Persijn J. Honkoop, MD,

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Presentation transcript:

Symptom- and fraction of exhaled nitric oxide–driven strategies for asthma control: A cluster-randomized trial in primary care Persijn J. Honkoop, MD, Rik J.B. Loijmans, MD, Evelien H. Termeer, MD, Jiska B. Snoeck-Stroband, PhD, Wilbert B. van den Hout, PhD, Moira J. Bakker, RN, Willem J.J. Assendelft, MD, PhD, Gerben ter Riet, PhD, Peter J. Sterk, MD, PhD, Tjard R.J. Schermer, PhD, Jacob K. Sont, PhD Journal of Allergy and Clinical Immunology Volume 135, Issue 3, Pages 682-688.e11 (March 2015) DOI: 10.1016/j.jaci.2014.07.016 Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 1 Consort flow diagram for the Asthma Control Cost-Utility Randomized Trial Evaluation (ACCURATE) trial. Six hundred forty-seven patients provided informed consent, of whom 31 withdrew before the first visit to general practice and before filling out online questionnaires. Because randomization was performed at the group level, they were randomized but were unaware of their strategy before withdrawal. Five participants visited their general practice once, but no analyzable data were available because they never filled out online questionnaires. Journal of Allergy and Clinical Immunology 2015 135, 682-688.e11DOI: (10.1016/j.jaci.2014.07.016) Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 2 Cost-effectiveness acceptability curve. This figure shows the probability that a strategy is the most cost-effective compared with the other 2 strategies at different willingness to pay per QALY levels from a societal perspective, which includes all health care costs and costs resulting from loss of productivity. Journal of Allergy and Clinical Immunology 2015 135, 682-688.e11DOI: (10.1016/j.jaci.2014.07.016) Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E1 Results of the ACQ (A) and Asthma Quality of Life Questionnaire (AQLQ; B) during the course of the study. The course of the results of the ACQ and AQLQ is depicted for the 3 strategies. Statistical differences during the study for the 3 pairwise combinations are provided. Journal of Allergy and Clinical Immunology 2015 135, 682-688.e11DOI: (10.1016/j.jaci.2014.07.016) Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E2 Medication use during the course of the study. The daily dose of ICSs in beclomethasone equivalents (A) and the mean amount of oral prednisone (B) in the past 3 months are depicted during the course of the study. These figures show that for both types of medication, the FCa strategy performance was optimal. Journal of Allergy and Clinical Immunology 2015 135, 682-688.e11DOI: (10.1016/j.jaci.2014.07.016) Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions