Publications by authors named "Hitesh N Gandhi"

Objective: Asthma is often inadequately controlled, which can result in exacerbations that lead to unplanned healthcare visits. Mobile application (app) use could help manage asthma exacerbations. We implemented the Amaze™ asthma disease management platform in clinical practice and assessed user satisfaction, usage, and usability.

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Article Synopsis
  • The study investigates the use of short-acting ß-agonist (SABA) and maintenance therapy in patients with mild persistent asthma who experienced serious exacerbations, categorized as hospital visits or urgent care needs.
  • Analyzed data from over 323,000 asthma patients from 2010 to 2017 revealed that prior to serious exacerbations, more patients filled SABA prescriptions compared to maintenance therapy, but after the event, they shifted to filling maintenance medications more frequently.
  • The findings suggest a potential "window of opportunity" to improve treatment strategies for preventing serious exacerbations by timely adjusting medication types before and after such events.
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Background: Asthma control assessment is based on impairment (current symptoms) and risk (exacerbation history).

Objective: To understand the extent of uncontrolled asthma, we assessed relationships between prescription fills for systemic corticosteroids (SCS) and short-acting β-agonists (SABA) as risk and impairment markers, respectively.

Methods: Annual SCS and SABA fills among US patients with asthma were evaluated by a retrospective analysis of the IQVIA Longitudinal Access and Adjudication Data.

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Background: Patient perception of medication onset of effect is important for adherence. Although the Onset of Effect Questionnaire (OEQ) has been validated in patients with asthma, it has not been evaluated in patients with chronic obstructive pulmonary disease (COPD). This study evaluated the COPD-OEQ in patients with COPD.

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Background: Complex models combining impairment-based control assessments with clinical characteristics and biomarkers have been developed to predict asthma exacerbations. The composite Asthma Impairment and Risk Questionnaire (AIRQ) with adjustments for demographics (age, sex, race, and body mass index) predicts 12-month exacerbation occurrence similarly to these more complex models.

Objective: To examine whether AIRQ exacerbation prediction is enhanced when models are adjusted for a wider range of clinical characteristics and biomarkers.

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Background: The Asthma Impairment and Risk Questionnaire (AIRQ) is a 10-item, yes/no, equally weighted control tool. Lower scores indicate better control. Moreover, 7 impairment items reflect previous 2-week symptoms, and 3 risk items assess previous 12-month exacerbations.

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Article Synopsis
  • The study investigates the effectiveness of anti-inflammatory therapies during a critical period before a severe asthma exacerbation in patients aged 4 years and older.
  • Analysis of data from 319,342 patients indicated that a significant percentage of both children (27.2%) and adults (16.8%) experienced serious asthma exacerbations, often using short-acting medications like SABA before the event.
  • Findings reveal that many patients increase their use of SABA prior to an exacerbation, yet about 40% do not utilize anti-inflammatory maintenance therapy, suggesting a missed opportunity to prevent worsening asthma symptoms.
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Background: Asthma control is often overestimated in routine practice, and despite advances in the understanding of immunopathology and the availability of new precision therapies, the burden of disease remains unacceptably high.

Objective: To compare the performance of the Asthma Impairment and Risk Questionnaire (AIRQ) with patient and physician assessments and the Asthma Control Test (ACT) in identifying asthma control.

Methods: Baseline data from a longitudinal study of the AIRQ were analyzed.

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Purpose: Critical asthma outcomes highlighted in clinical guidelines include asthma-related quality of life, asthma exacerbations, and asthma control. An easy-to-implement measure of asthma control that assesses both symptom impairment and exacerbation risk and reflects the impact of asthma on patients' lives is lacking. Hence, the objective of this study was to assess the Asthma Impairment and Risk Questionnaire (AIRQ) construct validity relative to patient self-perception of asthma status and validated disease-specific patient-reported outcome (PRO) measures.

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Background: The Asthma Impairment and Risk Questionnaire (AIRQ) is a 10-item, equally weighted, yes/no control tool validated in patients with asthma aged 12 years and older.

Objective: To evaluate AIRQ's ability to predict patient-reported exacerbations over 12 months.

Methods: Patients completed a baseline AIRQ during an in-person enrollment visit and reported exacerbations (ie, asthma-related courses of oral corticosteroids, emergency department/urgent care visits, and hospitalizations) via monthly online surveys.

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Background: Recurrent assessment of asthma control is essential to evaluating disease stability and intervention impacts. An assessment that can be administered between annual clinic visits is needed. The Asthma Impairment and Risk Questionnaire (AIRQ) is a cross-sectionally validated, 10-item, yes or no, composite control tool evaluating previous 2-week symptoms and previous 12-month exacerbations.

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Purpose: Exercise-induced bronchoconstriction (EIB) is generally treated with short-acting β-agonists (SABA) before exercising, to prevent symptoms. Real-world data on treatments and outcomes for patients with EIB alone (EIB), or with asthma (EIB), in the USA are limited. This study compared demographics, treatment patterns, morbidity, and costs of treating EIB between these two groups of patients.

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Background: Inhaled corticosteroids (ICS) are widely used and recommended to treat chronic obstructive pulmonary disease (COPD). While generally considered safe, several studies demonstrated an increased risk of pneumonia with the use of ICS in COPD patients. Although all ICS indicated for COPD carry the class labeling warning of increased pneumonia risk, evidence suggests an intraclass difference in the risk of pneumonia between inhaled budesonide and fluticasone.

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Background: Asthma exacerbation risk increases with worsening asthma control. Prevailing numerical control tools evaluate only current symptom impairment despite the importance of also assessing risk based on exacerbation history. An easy-to-use questionnaire addressing impairment and risk domains of control is needed.

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