AI Article Synopsis
- - The French RAMSES study compared severe asthma patients managed in tertiary referral centres (TRCs) versus secondary care centres (SCCs) to understand differences in patient characteristics and care practices.
- - A total of 2046 patients were included: 73.4% from TRCs and 26.6% from SCCs; key findings showed that TRC patients had more comorbidities but lower blood eosinophil counts and benefited more from educational programs and in-depth investigations.
- - The study concluded that asthma care trajectories and patient phenotypes varied significantly between TRCs and SCCs, emphasizing the need for standardized approaches to managing severe asthma.
Article Abstract
Background: The French RAMSES study is an observational prospective multicentre real-life cohort including severe asthmatic subjects. The objective of the study was to compare the characteristics of patients, in terms of phenotype and asthma care trajectories, between those managed by tertiary referral centres (TRCs) or secondary care centres (SCCs).
Methods: Patients were prospectively recruited and enrolled for a 5-year follow-up. Patients' characteristics were analysed at inclusion and compared between TRCs and SCCs.
Results: 52 centres (24 TRCs and 28 SCCs) included 2046 patients: 1502 (73.4%) were included by a TRC and 544 (26.6%) by a SCC. Patients were mainly women (62%), 53±15 years old, 67% with Asthma Control Test <20; at inclusion, 14% received oral corticosteroids (OCS) and 66% biologics. Compared with the SCC group, the TRC group had more frequent comorbidities and lower blood eosinophil counts (262 340 mm; p=0.0036). OCS and biologics use did not differ between groups, but patients in the TRC group benefited more frequently from an educational programme (26% 18%; p=0.0008) and received more frequently two or more sequential lines of biologics (33% 24%; p=0.0105). In-depth investigations were more frequently performed in the TRC group (allergy tests: 74% 62%; p<0.0001; exhaled nitric oxide fraction: 56% 21%; p<0.0001; induced sputum: 6% 3%; p=0.0390).
Conclusions: Phenotypes and care trajectories differed in the RAMSES cohort between SCCs and TRCs, probably related to different levels of asthma severity and differences in medical resources and practices among centres. This highlights the need for standardisation of severe asthma care.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11033728 | PMC |
| http://dx.doi.org/10.1183/23120541.00837-2023 | DOI Listing |
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