Browsing by Author "Mungan, D"
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Item Socioeconomic status has direct impact on asthma control: Turkish adult asthma registryArslan, B; Türk, M; Hayme, S; Aydin,Ö; Gokmen, D; Buhari, GK; Sozener, ZC; Gemicioglu, B; Bulut, I; Beyaz, S; Orcen, C; Ozdemir, SK; Keren, M; Damadoglu, E; Yakut, T; Kalpaklioglu, AF; Baccioglu, A; Yalim, SA; Yilmaz, I; Kalkan, IK; Niksarlioglu, EYO; Kalyoncu, AF; Karakaya, G; Erbay, M; Nayci, S; Tepetam, FM; Gelincik, AA; Dirol, H; Goksel, O; Karaoglanoglu, S; Erkekol, FO; Isik, SR; Yildiz, F; Yavuz, Y; Karadogan, D; Bozkurt, N; Seker, U; Oguzulgen, IK; Basyigit, I; Baris, SA; Ucar, EY; Erdogan, T; Polatli, M; Ediger, D; Gunaydin, FE; Pur, L; Katran, ZY; Sekibag, Y; Aykac, EF; Mungan, D; Gul, O; Cengiz, A; Akkurt, B; Ozden, S; Demir, S; Unal, D; Aslan, AF; Can, A; Gumusburun, R; Bogatekin, G; Akten, HS; Inan, S; Erdinc, M; Ogus, AC; Kavas, M; Yulug, DP; Cakmak, ME; Kaya, SB; Alpagat, G; Ozgur, ES; Uzun, O; Gulen, ST; Pekbak, G; Kizilirmak, D; Havlucu, Y; Donmez, H; Cetin, GP; Soyyigit, S; Kara, BY; Karakis, GP; Dursun, AB; Kendirlinan, R; Ozturk, AB; Sevinc, C; Simsek, GO; Abadoglu, O; Cerci, P; Yucel, T; Yorulmaz, I; Tezcaner, ZC; Tatar, EC; Suslu, AE; Ozer, S; Dursun, E; Yorgancioglu, A; Celik, GE; Uysal, MABackgroundAsthma is one of the most common causes of chronic respiratory disease, and countries with low socioeconomic status have both a high prevalence of asthma and asthma-related death.ObjectiveIn this study, we aimed to determine socioeconomic levels of asthmatic patients according to a national database and investigate the effects of social markers on disease control in our region.MethodsThis is an analysis of data from 2053 adult asthma patients from a multicentre chart study in Turkey. Socioeconomic status (SES) data were collected from questionnaires and this form was sent to the patients via e-mail. Parameters related to social status and poor disease control were analyzed.ResultsIlliteracy (OR:2.687 [95% CI: 1.235-5.848]; p = 0.013) and lower household income (OR:1,76 [95% CI: 1.002-3.09]; p = 0.049) were found as independent risk factors for hospitalization in the multivariate logistic regression analysis. Therewithal, being aged between 40 and 60 (OR: 1.435 [95% CI: 1.074-1.917]; p = 0.015), illiteracy (OR: 2.188 [95% CI: 1.262-3.795]; p = 0.005) and being employed (OR: 1.466 [95% CI: 1.085-1.847]; p = 0.011) were considered as independent risk factors for systemic corticosteroid use at least 3 days within last 1 year.ConclusionAs a result of our national database, education level, household income and working status briefly socioeconomic status have impacts on asthma control. Identification of social markers in asthma and better recognition of risk factors based on the population gives us clues to provide better asthma control in the future.Item Picturing asthma in Turkey: results from the Turkish adult asthma registryCelik, GE; Aydin, O; Gokmen, D; Buhari, GK; Sozener, ZC; Gemicioglu, B; Bulut, I; Beyaz, S; Orcen, C; Ozdemir, SK; Keren, M; Damadoglu, E; Yakut, T; Kalpaklioglu, AF; Baccioglu, A; Yalim, SA; Yilmaz, I; Kalkan, IK; Uysal, MA; Niksarlioglu, EY; Kalyoncu, AF; Karakaya, G; Erbay, M; Nayci, S; Tepetam, FM; Gelincik, AA; Dirol, H; Goksel, O; Karaoglanoglu, S; Erkekol, FO; Isik, SR; Yildiz, F; Yavuz, Y; Karadogan, D; Bozkurt, N; Seker, U; Oguzulgen, IK; Basyigit, I; Baris, SA; Ucar, EY; Erdogan, T; Polatli, M; Ediger, D; Gunaydin, FE; Turk, M; Pur, L; Katran, ZY; Sekibag, Y; Aykac, EF; Mungan, D; Gul, O; Cengiz, A; Akkurt, B; Ozden, S; Demir, S; Unal, D; Aslan, AF; Can, A; Gumusburun, R; Bogatekin, G; Akten, HS; Inan, S; Erdinc, M; Ogus, AC; Kavas, M; Yulug, DP; Cakmak, ME; Kaya, SB; Alpagat, G; Ozgur, ES; Uzun, O; Gulen, ST; Pekbak, G; Kizilirmak, D; Havlucu, Y; Donmez, H; Arslan, B; Cetin, GP; Soyyigit, S; Kara, BY; Karakis, GP; Dursun, AB; Kendirlinan, R; Ozturk, AB; Sevinc, C; Simsek, GO; Abadoglu, O; Cerci, P; Yucel, T; Yorulmaz, I; Tezcaner, ZC; Tatar, EC; Suslu, AE; Ozer, S; Dursun, E; Yorgancioglu, AIntroductionNational data on asthma characteristics and the factors associated with uncontrolled asthma seem to be necessary for every country. For this purpose, we developed the Turkish Adult Asthma Registry for patients with asthma aiming to take a snapshot of our patients, thereby assigning the unmet needs and niche areas of intervention.MethodsCase entries were performed between March 2018 and March 2022. A web-based application was used to record data. Study outcomes were demographic features, disease characteristics, asthma control levels, and phenotypes.ResultsThe registry included 2053 patients from 36 study centers in Turkey. Female subjects dominated the group (n = 1535, 74.8%). The majority of the patients had allergic (n = 1158, 65.3%) and eosinophilic (n = 1174, 57.2%) asthma. Six hundred nineteen (32.2%) of the patients had obese asthma. Severe asthma existed in 670 (32.6%) patients. Majority of cases were on step 3-5 treatment (n: 1525; 88.1%). Uncontrolled asthma was associated with low educational level, severe asthma attacks in the last year, low FEV1, existence of chronic rhinosinusitis and living in particular regions.ConclusionThe picture of this registry showed a dominancy of middle-aged obese women with moderate-to-severe asthma. We also determined particular strategic targets such as low educational level, severe asthma attacks, low FEV1, and chronic rhinosinusitis to decrease uncontrolled asthma in our country. Moreover, some regional strategies may also be needed as uncontrolled asthma is higher in certain regions. We believe that these data will guide authorities to reestablish national asthma programs to improve asthma service delivery.Item Trends in prescribing montelukast in patients with asthma in real-life: Results from the Turkish adult asthma registryBeyaz, S; Erdinç, M; Hayme, S; Aslan, AF; Aydin,Ö; Gökmen, D; Buhari, GK; Sözener, ZC; Gemicioglu, B; Bulut, I; Örçen, C; Özdemir, SK; Keren, M; Damadoglu, E; Yakut, T; Kalpaklioglu, AF; Baccioglu, A; Yalim, SA; Yilmaz, I; Kalkan, IK; Uysal, MA; Niksarlioglu, EYÖ; Kalyoncu, AF; Karakaya, G; Erbay, M; Nayci, S; Tepetam, FM; Gelincik, AA; Dirol, H; Göksel,Ö; Karaoglanoglu, S; Erkekol, FÖ; Isik, SR; Yildiz, F; Yavuz, Y; Karadogan, D; Bozkurt, N; Seker,Ü; Oguzülgen, IK; Basyigit, I; Baris, SA; Uçar, EY; Erdogan, T; Polatli, M; Ediger, D; Günaydin, FE; Türk, M; Pür, L; Katran, ZY; Sekibag, Y; Aykaç, EF; Mungan, D; Gül,Ö; Cengiz, A; Akkurt, B; Özden, S; Demir, S; Ünal, D; Can, A; Guemuesburun, R; Bogatekin, G; Akten, HS; Inan, S; Ögüs, AC; Kavas, M; Yulug, DP; Çakmak, ME; Kaya, SB; Alpagat, G; Özgür, ES; Uzun, O; Gülen, ST; Pekbak, G; Kizilirmak, D; Havlucu, Y; Doenmez, H; Arslan, B; Çetin, GP; Soyyigit, S; Kara, BY; Karakis, GP; Dursun, AB; Kendirlinan, R; Öztürk, AB; Sevinç, C; Simsek, GÖ; Abadoglu,Ö; Çerçi, P; Yücel, T; Yorulmaz, I; Tezcaner, ZÇ; Tatar, EÇ; Süslü, AE; Özer, S; Dursun, E; Yorgancioglu, A; Çelik, GEMontelukast, a leukotriene receptor antagonist (LTRA) approved for the treatment of asthma and allergic rhinitis, is widely used, though real-world data on its application in asthma management remain limited. This registry-based study evaluated the use of montelukast in adult asthma patients, examining demographic and disease characteristics, asthma control status, asthma phenotypes, presence of atopy, and treatment regimens. Among 2053 patients analyzed, 61.76% (n = 1268; mean age: 46.2 +/- 14.3 years), predominantly females (similar to 76%), received montelukast. Montelukast users showed higher rates of allergic rhinitis (P < 0.001), hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs) (P = 0.008), and chronic rhinosinusitis (P = 0.008). Montelukast group also had higher atopy and total IgE levels and tended to be more eosinophilic. Montelukast was commonly preferred in allergic, eosinophilic, NSAID-exacerbated respiratory disease, and severe asthma phenotypes (P < 0.001). Patients receiving Steps 4 and 5 treatments are more likely to be prescribed montelukast (P < 0.001). Montelukast usage was higher among patients with uncontrolled asthma [ACT< 20 (OR:1.29, 95%CI:1.052-1.582, P = 0.014)]. In addition, logistic regression analyses identified the main factors associated with increased montelukast use as; female gender (OR:1.33, 95%CI:1.041-1.713, P = 0.02), presence of atopy (OR:1.46, 95%CI:1.157-1.864, P = 0.002), comorbid allergic rhinitis (OR:2.12, 95%CI:1.679-2.293, P < 0.001), and severe asthma (OR:2.18, 95%CI:1.712-2.784, P < 0.001). These findings reveal that montelukast use is prevalent among asthma patients, particularly in females, middle-aged adults, and those with comorbid allergic rhinitis, uncontrolled asthma, or specific asthma phenotypes, underscoring the factors that influence its prescription in asthma management. (c) 2025 Codon Publications. Published by Codon Publications.Item Factors influencing the prescription of add-on long-acting muscarinic antagonists in real-world asthma management: Insights from a national registryGemicioglu, B; Gokmen, D; Can, A; Sevinc, C; Oguzulgen, IK; Soyyigit, S; Yakut, T; Havlucu, Y; Aydin, O; Buhari, GK; Sozener, ZC; Bulut, I; Beyaz, S; Orcen, C; Ozdemir, SK; Keren, M; Damadoglu, E; Kalpaklioglu, AF; Baccioglu, A; Yalim, SA; Yilmaz, I; Kalkan, IK; Uysal, MA; Niksarlioglu, EYO; Kalyoncu, AF; Karakaya, G; Erbay, M; Nayci, S; Tepetam, FM; Gelincik, A; Dirol, H; Goksel, O; Karaoglanoglu, S; Erkekol, FO; Isik, SR; Yildiz, F; Yavuz, Y; Karadogan, D; Bozkurt, N; Seker, U; Basyigit, I; Baris, SA; Ucar, EY; Erdogan, T; Polatli, M; Ediger, D; Gunaydin, FE; Turk, M; Pur, L; Katran, ZY; Sekibag, Y; Aykac, EF; Mungan, D; Gul, O; Cengiz, A; Akkurt, B; Ozden, S; Demir, S; Unal, D; Aslan, AF; Gumusburun, R; Bogatekin, G; Akten, HS; Inan, S; Erdinc, M; Ogus, AC; Kavas, M; Yulug, DP; Cakmak, ME; Kaya, SB; Alpagat, G; Ozgur, ES; Uzun, O; Gulen, ST; Pekbak, G; Kizilirmak, D; Donmez, H; Arslan, B; Cetin, GP; Kara, BY; Dursun, AB; Karakis, GP; Kendirlinan, R; Ozturk, AB; Simsek, GO; Abadoglu, O; Cerci, P; Yucel, T; Yorulmaz, I; Tezcaner, ZC; Tatar, EC; Suslu, AE; Ozer, S; Dursun, E; Yorgancioglu, A; Çelik, GECurrent guidelines recommend adding long-acting muscarinic antagonists (LAMAs) in patients with uncontrolled asthma, despite the use of moderate to high doses of inhaled steroid-long-acting beta agonists (ICS/LABA). This study aims to analyze the factors related to the prescription of add-on LAMA in clinical practice for asthma patients, shedding light on physicians' preferences. This study included adult asthma patients on add-on LAMA and ICS/LABA monitored for at least one year in a national registry comprising 2053 asthmatics. Patients' characteristics and disease profiles were analyzed to identify factors associated with the prescription of add-on LAMA across the entire cohort. A comparative analysis was performed among three groups: MART (ICS/formoterol as a maintenance and reliever therapy) plus LAMA, Conventional (ICS/LABA as a maintenance and short-acting beta agonist as reliever) plus LAMA and Triple (ICS/ LABA/LAMA single inhaler). LAMAs were added to ICS/LABA in 11.7 % of patients in the national registry. Logistic regression analysis revealed that older age, low FEV1 (%), Asthma Control Test (ACT) scores less than 20, and severe exacerbation were the main factors influencing the initiation of LAMA in our registry. However, demographic characteristics of asthma, control status, pulmonary function test results were similar among the three groups of LAMA users (p > 0.05). Physicians used LAMAs without phenotyping based on allergic status or eosinophil levels (p > 0.05). Mepolizumab was added after LAMA in all patients, while omalizumab was initiated before LAMA in 16.9 % of the patients receiving LAMA along with biologics. Add-on LAMAs were predominantly prescribed for older, uncontrolled, and exacerbated asthma patients with low FEV1.Item Asthma in elderly in Turkey: a multicenter studyGemicioglu, B; Mungan, D; Ogus, C; Erkekol, FO; Dursun, B; Saka, D; Yorgancioglu, A; Topcu, F; Bogatekin, G; Deveci, F; Turktas, H; Bayram, H; Kalyoncu, F; Tor, M; Yildiz, FItem Long-Term Omalizumab Treatment: A Multicenter, Real-Life, 5-Year TrialYorgancioglu, A; Erkekol, FÖ; Mungan, D; Erdinç, M; Gemicioglu, B; Özseker, ZF; Degirmenci, PB; Nayci, S; Çilli, A; Erdenen, F; Kirmaz, C; Ediger, D; Yalçin, AD; Büyüköztürk, S; Öztürk, S; Güleç, M; Isik, SR; Kalyoncu, AF; Göksel, Ö; Aydin, O; Havlucu, Y; Ar, IB; Erdogdu, ABackground: Omalizumab has demonstrated therapeutic benefits both in controlled clinical trials and real-life studies. However, research concerning the long-term effects and tolerability of omalizumab is needed. The main objective of this study was to evaluate the effectiveness and tolerability of treatment with omalizumab for up to 5 years. Methods: A multicenter, retrospective, chart-based study was carried out to compare documented exacerbations, hospitalizations, systemic steroid requirement, FEV1, and asthma control test (ACT) results during 1 year prior to omalizumab treatment versus at 1, 3, and 5 years of treatment. Adverse events and reasons for discontinuation were also recorded at each time point. Results: Four hundred and sixty-five patients were enrolled in the study. Outcome variables had improved after the 1st year and were sustained after the 3rd and 5th years of treatment with omalizumab. Omalizumab treatment reduced the asthma exacerbation rate by 71.3% (p < 0.001) at 1 year, 64.3% (p < 0.001) at 3 years, and 54.8% (p = 0.002) at 5 years. The hospitalization rate also decreased; by the 5th year of the treatment no patients were hospitalized. ACT results had also improved significantly: 12 (p < 0.001) at 1 year, 12 (p < 0.001) at 3 years, and 12 (p = 0.002) at 5 years. Overall, 12.7% of patients reported adverse events (most of these were mild-to-moderate) and the overall dropout rate was 9.0%. Conclusion: Omalizumab had a significant effect on asthma outcomes and this effect was maintained over 5 years. The drug was found to be generally safe and treatment compliance was good. (C) 2018 S. Karger AG, BaselItem The validation of the Turkish version of Asthma Control Test (vol 22, pg 1773, 2013)Uysal, MA; Mungan, D; Yorgancioglu, A; Yildiz, F; Akgun, M; Gemicioglu, B; Turktas, H; Ozkan, G; Yilmaz, I; Incioglu, M; Boyaci, H; Atis, S; Yalcin, A; Bayram, NG; Deveci, F; Pulur, D; Ozgur, ES; Dursun, B; Bulbul, Y; Sulu, E; Yilmaz, VItem Asthma control test administered by web-based text messaging (short message service-SMS): Is it comparable with paper form?Uysal, MA; Mungan, D; Yorgancioglu, A; Yildiz, F; Akgun, M; Gemicioglu, B; Ozkan, G; Yilmaz, I; Incioglu, M; Boyaci, H; Atis, S; Yalcin, A; Bayram, NG; Deveci, F; Pulur, D; Özgür, ES; Dursun, B; Bülbül, Y; Sulu, E; Yilmaz, V; Turktas, HItem Asthma phenotypes in Turkey: a multicenter cross-sectional study in adult asthmatics; PHENOTURK studyYildiz, F; Mungan, D; Gemicioglu, B; Yorgancioglu, A; Dursun, B; Erkekol, FO; Ogus, C; Turktas, H; Bogatekin, G; Topcu, F; Deveci, F; Bayram, H; Tor, M; Kalyoncu, AFBackground and AimsTo evaluate asthma phenotypes in patients with asthma from different regions of Turkey. MethodsA total of 1400 adult asthmatic patients (mean (SD) age: 44.0 (13.9) years, 75% females) from 14 centers across Turkey were included in this study and a standard questionnaire was applied between the time period of February 2011-January 2012. ResultsThe disease onset40 years of age was higher percentage in obese vs. normal/overweight patients and nonallergic vs. allergic patients (P<0.01). The percentage of patients who had FEV1 values over 80% was higher in allergic than nonallergic and normal/overweight than obese patients (P<0.01). Uncontrolled asthmatics have more severe disease (P<0.01). There were more frequent hospital admissions in nonallergic and uncontrolled asthmatics (P<0.01). Chronic rhino-sinusitis was the leading comorbid disorder in normal/overweight and allergic asthma, while gastroesophageal reflux disorder was more frequent in nonallergic and uncontrolled asthma (P<0.01). Asthma control rate was the highest (39.0%) in patients from Marmara region among all geographical regions (P<0.05). ConclusionIn conclusion, our findings revealed existence of clinical/trigger related phenotypes based on BMI, allergic status, control level and geographical region with more frequent respiratory dysfunction and/or adverse health outcomes in uncontrolled, obese and nonallergic phenotypes.Item Asthma-chronic obstructive pulmonary disease overlap: Results from a national-multicenter studyÇelik, GE; Aydin, O; Sen, E; Demir, T; Gemicioglu, B; Kiyan, E; Mungan, D; Kivilcim Oguzülgen, I; Polatli, M; Göksel, Ö; Sayiner, A; Yildirim, N; Yildiz, F; Yorgancioglu, A; Elhan, AH; Yildiz, Ö; Basyigit, I; Börekçi, S; Havlucu, Y; Okumus, G; Türk, M; Saryal, SIntroduction: Patients with asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) have a greater disease burden than those with COPD or asthma alone. In this study, it was aimed to determine the prevalence, risk factors, and clinical features of ACO because there are limited national data in T & uuml;rkiye. Materials and Methods: The study was conducted in a cross-sectional design in nine tertiary-care hospitals. The patients followed with a diagnosis of asthma or COPD for at least one year were enrolled in the study. The frequency of ACO and the characteristics of the patients were evaluated in the asthma and COPD groups Results: The study included 408 subjects (F/M= 205/203, mean age= 56.24 +/- 11.85 years). The overall prevalence of ACO in both groups was 20.8% (n= 85). The frequency was higher in the COPD group than in the asthma group (n= 55; 33.3% vs. n= 22; 9.8%), respectively (p= 0.001). Patients with ACO had similarities to patients with COPD in terms of advanced age, sex, smoking, exposure to biomass during childhood, being born in rural areas, and radio-logic features. Characteristics such as a history of childhood asthma and allergic rhinitis, presence of chronic sinusitis, NSAID hypersensitivity, atopy, and high eosinophil counts were similar to those of patients with asthma (p< 0.001). The annual decline in FEV1 was more prominent in the ACO group (mean= -250 mL) than in the asthma (mean change= -60 mL) and COPD (mean change= -230 mL) groups (p= 0.003). Conclusion: This study showed that ACO was common among patients with asthma and COPD in tertiary care clinics in our country. ACO should be considered in patients with asthma and COPD who exhibit the above mentioned symptomsItem Asthma phenotypes in Turkey: A multicenter studyYildiz, F; Mungan, D; Gemicioglu, B; Dursun, B; Saka, D; Yorgancioglu, A; Erkekol, FO; Ogus, C; Turktas, H; Bogatekin, G; Topcu, F; Deveci, F; Bayram, H; Tor, M; Kalyoncu, FItem Asthma control test via text messaging: could it be a tool for evaluating asthma control?Uysal, MA; Mungan, D; Yorgancioglu, A; Yildiz, F; Akgun, M; Gemicioglu, B; Turktas, HIntroduction: Originally, the Asthma Control Test (ACT) was designed for English-speaking patients using a paper-and-pencil format. The Turkish version of the ACT was recently validated. This article compares the paper-and-pencil and web-based texting formats of the Turkish version of the ACT and evaluates the compatibility of these ACT scores with GINA-based physician assessments of asthma control. Methods: This multicentre prospective study included 431 asthma patients from outpatient clinics in Turkey. The patients were randomized into a paper-and-pencil group (n = 220) and a text messaging group (n = 211). Patients completed the ACT at Visit 1, after 10 +/- 2 days, and at 5 +/- 1 week to demonstrate the reliability and responsiveness of the test. At each visit, physicians assessed patients' asthma control levels. Results: The ACT administered via texting showed an internal consistency of 0.82. For the texting group, we found a significant correlation between the ACT and physician assessments at Visit 1 (r = 0.60, p < 0.001). The AUC was 0.87, with a sensitivity of 78.0% and a specificity of 77.5% for a score of <= 19 for screening uncontrolled asthma in the texting group. Conclusion: When the Turkish version of the ACT was administered via either the paper-and-pencil or text messaging test, scores were closely associated with physician assessments of asthma control.Item Asthma-COPD overlap syndromeSen, E; Oguzülgen, K; Bavbek, S; Günen, H; Kiyan, E; Türktas, H; Yorgancioglu, A; Polatli, M; Yildiz, F; Çelik, G; Demir, T; Gemicioglu, B; Mungan, D; Saryal, S; Sayiner, A; Yildirim, NAsthma and chronic obstructive pulmonary disease (COPD) are common lung diseases characterized by chronic airway inflammation and airway obstruction. Among patient with COPD and asthma; there is a group of patients with an overlap between clinical, functional characteristics and airway inflammation patterns, named Asthma-COPD Overlap Syndrome (ACOS). ACOS is a syndrome characterized by reversible but persistant airflow limitation (postbronchodilator FEV1/FVC < 70%) which has some features of both asthma and COPD. ACOS should be suspected in a patient > 40 years, with smoking history, previous asthma diagnosis or history of childhood asthma who has persistant airflow limitation and reversible ariway obstruction (defined by an increase of > % 12 of FEV1 pred or increase of FEV1 > 200 mL after inhalation of 400 mcg salbutamol or 1000 mcg terbutaline). The prevalence for ACOS has been reported 11-55% in different case series to date and increases by age and is more frequent in females in different age groups. Patients with ACOS are younger than COPD patients and older than asthma patients. Frequent and severe exacerbations and related hospitalization and emergency room visits are common in ACOS and this causes an impaired quality of life. Current recommendations of guidelines for pharmacologic treatment of ACOS have been composed of a combination with optimal COPD and asthma treatment. Future therapeutic approaches should be based on endotypes. Clinical phenotype and underlying endotype driven clinical studies may be the base of ACOS guidelines.Item Acute exacerbation in COPD and asthmaYildirim, N; Demir, T; Gemicioglu, B; Kiyan, E; Oguzülgen, K; Polatli, M; Saryal, S; Sayiner, A; Yorgancioglu, A; Bavbek, S; Çelik, GE; Günen, H; Mungan, D; Sen, E; Türktas, H; Yildiz, FChronic obstructive pulmonary disease (COPD) and asthma are airway diseases with acute exacerbations. Natural course of both disease are affected by exacerbations. COPD exacerbations may be caused by infections and other causes; indoor and outdoor pollution, cardiovascular diseases, asthma-COPD overlap syndrome, COPD-obstructive sleep apnea syndrome, pulmonary embolism, gastro-oesophageal reflux, anxiety-depression, pulmonary hypertension. Exposure to triggering factors, viral infections, treatment insufficiency may cause asthma exacerbations. Smoking cessations, prevention of infections, long-acting anticholinergics, long-acting beta 2 agonists, inhaled corticosteroids, phosphodiesterase-4 inhibitors, mucolytics, prophilactic antibiotics can be effective on the prevention of COPD exacerbations. Asthma exacerbations may be decreased by the avoidance of allergens, viral infections, occupational exposures, airpollution, treatment of comorbid diseases. Effective treatment of asthma is required to prevent asthma exacerbations. Inhaled steroids and combined treatments are the most effective preventive therapy for exacerbations. Patient education and cooperation is an element of the preventive measures for asthma attacks. Compliance to therapy, inhalation techniques, written asthma plans are required. The essential of COPD and asthma exacerbation treatment is bronchodilator therapy. Steroids are also implemented to the therapy, targeting the inflammation. Specific treatments of the cause (infection, airpollution, pulmonary embolism etc.) should be administered.Item Prevalence and Risk Factors of Allergies in Turkey (PARFAIT): results of a multicentre cross-sectional study in adultsKurt, E; Metintas, S; Basyigit, I; Bulut, I; Coskun, E; Dabak, S; Deveci, F; Fidan, F; Kaynar, H; Uzaslan, EK; Onbasi, K; Ozkurt, S; Karakis, GP; Sahan, S; Sahin, U; Oguzulgen, K; Yildiz, F; Mungan, D; Yorgancioglu, A; Gemicioglu, B; Kalyoncu, AFThe Prevalence and Risk Factors of Allergies in Turkey (PARFAIT) study was planned to evaluate the prevalence of and risk factors for asthma and allergic diseases in Turkey. The present analysis used data from 25,843 parents of primary school children, obtained from a cross-sectional questionnaire-based study. A total of 25,843 questionnaires from 14 centres were evaluated. In rural areas, the prevalences asthma, wheezing, allergic rhinitis and eczema in males were: 8.5% (95% confidence interval (CI) 7.9-9.1%), 13.5% (95% Cl 12.8-14.2%), 17.5% (95% Cl 16.7-18.2%) and 10.8% (95% Cl 10.2-11.4%), respectively; and in females were: 11.2% (95% Cl 10.9-11.8%), 14.7% (95% Cl 14.3-15.1%), 21.2% (95% Cl 20.4-22.0%) and 13.1% (95% Cl 12.4-13.8%), respectively. In urban areas, the corresponding prevalences in males were: 6.2% (95% Cl 5.8-6.6%), 10.8% (95% Cl 10.3-11.3%), 11.7% (95% Cl 11.4-12.0%) and 6.6% (95% Cl 6.2-7.0%), respectively; and in females were: 7.5% (95% Cl 7.9-7.1%), 12.0% (95% Cl 11.7-12.3%), 17.0% (95% Cl 16.4-17.6%) and 7.3% (95% Cl 6.9-7.7%), respectively. Having an atopic first-degree relative or any other atopic diseases had significant effects on the prevalence of allergic diseases. Housing conditions, such as living in a shanty-type house, visible moulds at home and use of wood or biomass as heating or cooking material were associated with one or more allergic diseases. Although genetic susceptibility is strongly associated, country- and population-based environmental factors may contribute to increased prevalence rates of allergic diseases.Item Assessing the knowledge in primary health care following an educational course structured in the context of GARD chronic airway diseases national control programErkekol, FÖ; Köktürk, N; Mungan, D; Saçkesen, C; Önen, ZP; Özkan, S; Balkan, A; Ergün, P; Kocabas, CN; Aksakal, NB; Ekici, B; Altunay, ZÖ; GemIcIoglu, B; Yorgancioglu, AIntroduction: Chronic obstructive pulmonary diseases are common causes of disease in the community and account for considerable percent of the caseload in primary health care facilities. For this reason, it is important to question and improve the knowledge of primary health care physicians. This study is designed to assess the level of knowledge for bronchial asthma and COPD of the primary healthcare physicians, both before and immediately after an educational course structured in the context of GARD Chronic Airway Diseases National Control Program. Materials and Methods: The participating physicians attended an intensive educational course on asthma and COPD. Twenty five item questionnaires for asthma and COPD were administered to the participants both before and immediately after the end of the course. Contribution of education to the level of knowledge was investigated by comparing the percentages of the correct answers in the pre-and post-test. Results: From 11 different cities, 1817 and 1788 primary health care physician were attended to the asthma and COPD educations, respectively. The accuracy rate of >= 75% was obtained from only 4 questions in pre-test asthma questionnaire. On the contrary, in 15 questions the accuracy rate was < 50%. The mean accuracy rate for the whole asthma test was 45.8%, and this rate raised to 69.6% after education course. The accuracy rate of >= 75% could not be obtained from any of the questions in pre-test COPD questionnaire. On the contrary, in 19 questions the accuracy rate was < 50%. The mean accuracy rate for the whole asthma test was 42.0%, and this rate raised to 71.3% after education course. Conclusion: It has been shown that, in primary care settings, the level of knowledge in asthma and COPD should be enhanced and that this increase can be achieved with an education course.Item Prevalence and risk factors of allergies in Turkey: Results of a multicentric cross-sectional study in childrenKurt, E; Metintas, S; Basyigit, I; Bulut, I; Coskun, E; Dabak, S; Deveci, F; Fidan, F; Kaynar, H; Uzaslan, EK; Onbasi, K; Ozkurt, S; Pasaoglu, G; Sahan, S; Sahin, U; Oguzulgen, K; Yildiz, F; Mungan, D; Yorgancioglu, A; Gemicioglu, B; Kalyoncu, AFThe Prevalence And Risk Factors of Allergies in Turkey (PARFAIT) study was planned to evaluate prevalence and risk factors of asthma and allergic diseases and also to find out which geographical variables and/or climatic conditions play a role determining the prevalence of allergic diseases in Turkish school children. Study was planned as cross-sectional questionnaire-based. About 25,843 questionnaires from 14 centers were appropriate for analysis. Parental history of allergy, having an atopic sibling and other atopic disease in index case was significant risk factors for all allergic diseases. Breast feeding decreased the risk of current asthma (OR: 0.92, CI: 0.86-0.99) and wheezing (OR: 0.93, CI: 0.87-0.99) but not allergic rhinitis and eczema. Respiratory infection in the past was an important risk factor for the occurrence of allergic diseases especially for asthma which was increased 4.53-fold. Children exposed to household smoke were significantly at higher risk of asthma, wheezing, and allergic rhinitis (OR: 1.20, CI: 1.08-1.33; OR: 1.21, CI: 1.09-1.34; and OR: 1.32, CI: 1.21-1.43, respectively). All allergic diseases were increased in those children living in areas which have altitude of below 1000 m and mean yearly atmospheric pressure above 1000 mb. The study has suggested that household and country-specific environmental factors are associated with asthma, wheezing, allergic rhinitis, and eczema risk during childhood in Turkey.Item Stepwise Approach in Asthma Revisited 2023: Expert Panel Opinion of Turkish Guideline of Asthma Diagnosis and Management GroupÇelik, GE; Aydin, Ö; Damadoglu, E; Baççioglu, A; Özdemir, SK; Bavbek, S; Ediger, D; Erkekol, FÖ; Gemicioglu, B; Isik, SR; Kalpaklioglu, AF; Kalyoncu, AF; Karakaya, G; Keren, M; Mungan, D; Oguzülgen, IK; Yildiz, F; Yilmaz, I; Yorgancioglu, AIntroduction of inhaled corticosteroids (ICS) has been the cornerstone of the long-term management of asthma. ICSs either alone or in combination with long-acting beta-2 agonists have been shown to be associated with favorable asthma outcomes. However, asthma con-trol is still reported to be below expectations all around the world. Research in the last decades focusing on the use of ICS/formoterol both as maintenance and as needed (maintenance and reliever therapy approach) showed improved asthma outcomes. As a result of recent developments, Turkish Asthma Guidelines group aimed to revise asthma treatment recommendations. In general, we recommend physi-cians to consider the risk factors for poor asthma outcomes, patients' compliance and expectations and then to determine a personalized treatment plan. Importantly, the use of short-acting beta-2 agonists alone as a symptom reliever in asthma patients not using regular ICS is no longer recommended. In stepwise treatment approach, we primarily recommend to use ICS-based controllers and initiate ICS as soon as possible. We define 2 different treatment tracks in stepwise approaches as maintenance and reliever therapy or fixed-dose therapy and equally recommend each track depending on the patient's risks as well as decision of physicians in a personalized manner. For both tracks, a strong recommendation was made in favor of using add-on treatments before initiating phenotype-specific treatment in step 5. A strong recommendation was also made in favor of using biologic agents and/or aspirin treatment after desensitization in severe asthma when indicated.Item Evaluation of asthma and COPD awareness in primary care doctors in TurkeyErsu, R; Karakoç, GB; Yildiz, F; Köktürk, N; Mungan, D; Ekinci, B; Gemicioglu, B; Yorgancioglu, AAIntroduction: Chronic pulmonary diseases cause significant morbidity and mortality. However awareness about the risk factors, symptoms, diagnosis and traetment of these disorders is low among patients and health care providers. Our aim was to evaluate the awareness of asthma and chronic obstructive pulmonary disease among primary care doctors. This study was performed by the national Global Alliance Against Chronic Respiratory Diseases programme. Material and Methods: Primary care doctors employed by the Ministry of Healthy were included to the study. Turkish Statistical Institute randomly selected 680 doctors. Questionnaires evaluating the awareness of asthma and COPD which were developed by the Turkish Thoracic Society COPD and asthma assemblies were completed online by these doctors. Results: 84% of the doctors described asthma as airway obstruction. Dyspnea was reported as the most common symptom of asthma (78.8%) and inspiratory rhonci was reported as the most common physical exam finding (42.3%). Around 50% of doctors thought impairment of pulmonary function tests (PFT) was important for diagnosis and evaluation of severity of asthma while 24.2% thought physical exam was more important. When treatment options were evaluated 87.6% chose inhaled treatment for asthma. COPD was described as bronchiectasis and chronic bronchitis by 9.1%, chronic bronchitis and emphysema by 61.6%, chronic bronchitis and asthma by 22.2% and asthma and emphysema by 7.1%. 1.2% of the doctors did not consider cigarette smoking as a risk factor for COPD. PFT was recommended for diagnosis by 83%. Most correctly differentiated asthma and COPD. Bronchodilators were the first choice for COPD by 72.5%. Conclusion: Awareness is low for asthma and COPD among primary care doctors. Awareness should be raised among health care professionals for these diseases with high economical burden to improve outcome.Item Economic burden of severe asthma in Turkey: a cost of illness study from payer perspectiveBavbek, S; Malhan, S; Mungan, D; Misirligil, Z; Erdinc, M; Gemicioglu, B; Oguzulgen, IK; Oksuz, E; Yildiz, F; Yorgancioglu, AObjective. To estimate economic burden of severe asthma in Turkey from payer perspective based on expert panel opinion on practice patterns in clinical practice. Methods. This cost of illness study was based on identification of per patient annual direct medical costs for the management of severe asthma in Take, from payer perspective. Average per patient direct medical cost was calculated based on cost items related to outpatient visits laboratory and radiological tests, hospitalizations and interventions drug treatment and equipment, and co-morbidities/complications. Results. Based on total annual per patient costs calculated for outpatient admission ($177.91), laboratory and radiological tests ($ 8232), hospitalization/interventions ($1,154.55), drug treatment/equipment ($2,289.63) and co-morbidities ($ 661.39) cost items, total per patient annual direct medical cost related to management of severe asthma was calculated to be $ 4,369.76 from payer perspective. Drug treatment/equipment (524%) was the main cost driver in the management of severe asthma in Turkey, as followed by hospitalizations/interventions (264%) and co-morbidities (15.2%). Conclusions. In conclusion, our findings indicate that managing patients with severe asthma pose a considerable burden to health economics in Turkey with medications as the main cost driver.