Purpose: A Regional Technical Commission was set in 2017 by Veneto region (Italy) to provide opinions and recommendations on drug prescriptions and to implement treatment-pathway guidelines for severe asthma. In this observational study, we describe the first structured, integrated, multidisciplinary, patient-centered outpatient clinic for the care of severe-asthma patients in Italy, and characterize patients referring to the center for specialist visits.
Patients and Methods: To characterize patients that accessed the outpatient clinic in 2018, data on demographic characteristics, treatments, severity of asthma, phenotypes, and relevant comorbidities by phenotype were collected. Use of biologic agents and indicators of the performance of the outpatient clinic were described.
Results: A structured multidisciplinary outpatient pathway for taking charge of patients and for administration and monitoring of biological agents was developed. A total of 146 patients accessed the outpatient clinic in 2018: 62.3% had uncontrolled asthma upon admission and 27.4% were already being treated with biologic agents. Among patients with uncontrolled asthma, 66% had severe uncontrolled asthma, 22% had moderate–severe uncontrolled asthma, and 12% had mild–moderate uncontrolled asthma. Main asthma phenotypes in uncontrolled-asthma patients were allergic (58% of patients), eosinophilic (22%), allergic plus eosinophilic (10%) and non-atopic asthma (10%). Among patients affected by severe asthma, 47% had allergic asthma, 28% had eosinophilic asthma, 13% had allergic plus eosinophilic asthma, and 12% had non-atopic asthma. Nasal polyps were more frequent in eosinophilic and allergic plus eosinophilic asthma, while gastro-esophageal reflux disease was more frequent in non-atopic asthma.
Conclusion: This structure of an outpatient clinic for the treatment of severe asthma, with its dedicated pathway and multidisciplinary approach, may allow a stricter control of asthma and optimization of therapies, as well as minimization of drug misuse.

Keywords: asthma, severe, multidisciplinary, outpatient


中文翻译：

---

意大利重症哮喘诊治门诊首年活动组织、临床及管理指标

目的： 2017 年，威尼托大区（意大利）成立了一个区域技术委员会，就药物处方提供意见和建议，并实施严重哮喘的治疗途径指南。在这项观察性研究中，我们描述了意大利第一个结构化的、综合的、多学科的、以患者为中心的门诊诊所，用于治疗重度哮喘患者，并描述了转诊到专科就诊中心的患者。
患者和方法：为了描述 2018 年门诊就诊的患者，收集了人口学特征、治疗方法、哮喘严重程度、表型和表型相关合并症的数据。描述了生物制剂的使用和门诊表现的指标。
结果：开发了一种结构化的多学科门诊途径，用于负责患者以及管理和监测生物制剂。2018 年共有 146 名患者就诊：62.3% 的患者入院时哮喘未得到控制，27.4% 的患者已经在接受生物制剂治疗。在哮喘未控制患者中，66% 患有严重未控制哮喘，22% 患有中度至重度未控制哮喘，12% 患有轻度至中度未控制哮喘。未控制哮喘患者的主要哮喘表型是过敏性（58% 的患者）、嗜酸性粒细胞性哮喘（22%）、过敏性加嗜酸性粒细胞性哮喘（10%）和非特应性哮喘（10%）。在受重度哮喘影响的患者中，47% 患有过敏性哮喘，28% 患有嗜酸性哮喘，13% 患有过敏性加嗜酸性哮喘，12% 患有非特应性哮喘。
结论：这种治疗重度哮喘的门诊结构，具有专门的路径和多学科方法，可以更严格地控​​制哮喘和优化治疗，以及最大限度地减少药物滥用。

关键词：哮喘，严重，多学科，门诊