Brazilian Journal of Pulmonology

ISSN (on-line): 1806-3756 | ISSN (printed): 1806-3713


Publication continuous and bimonthly

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Avaliação da qualidade de vida na asma

Ana Luisa Godoy Fernandes, Maria Alenita de Oliveira

J Bras Pneumol.1997;23(3):148-152


Cost-effectiveness of an education program for asthmatic adults of a public university hospital

Custo-efetividade de programa de educação para adultos asmáticos atendidos em hospital-escola de instituição pública

Maria Alenita de Oliveira, Maria Tereza Muniz, Lucia Ande Santos, Sônia Maria Faresin, Ana Luisa Godoy Fernandes

J Bras Pneumol.2002;28(2):71-76

Abstract PDF PT

The direct costs incurred in managing patients with poorly controlled asthma are high and educational programs could decrease these costs. Aim: The objectives of this study were to compare the direct cost of the implementation of an educational program for adult asthmatic patients with the cost of the usual care delivered to asthmatics by specialists. Methods: Five years ago, a six-month study demonstrated that an educational program improved clinical outcomes (22 in educational program-E and 20 patients in control group-C). Throughout the educational intervention period all cases of hospitalization, emergency and regular calls involving patients from both groups were recorded. The basis for the values utilized in the calculation of costs was the healthcare database of the Brazilian government (DATASUS). The overall medication cost/patient in both groups was based on the amount of medication taken during the month preceding the last call. The final values were converted into US dollars. Results: The mean direct cost/patient in the educational (E) and control (C) groups and the difference (Δ) between groups were: hospitalizations (C = US$ 183, E = 0, Δ = US$ 183); emergency calls (C = US$ 14, E = US$ 5, Δ = US$ 9); regular calls (C = US$ 10, E = US$ 24, Δ = -US$ 14); medication (C = US$ 124,3, E = US$ 195,6, Δ = -US$ 71,3). The total cost was US$ 33/patient in group C and US$ 224/patient in group E with an average cost saving of US$ 107/patient. Conclusion: The expenses with medication is higher in E group because the regular use of maintenance drugs, however the study suggested that the application of the asthma education program reduced the total direct costs of asthma.


Keywords: Asthma. Cost-benefit. Patient education.


Education of the asthmatic patient: the nursing approach

Educação de pacientes com asma: atuação do enfermeiro

Ana Rita de Cássia Bettencourt, Maria Alenita de Oliveira, Ana Luisa Godoy Fernandes, Miguel Bogossian

J Bras Pneumol.2002;28(4):193-200

Abstract PDF PT

Background: Asthma education programs induce better asthma control and are one of main recommendations in guidelines. The programs recommendations should include a nurse in the educational team applying the structured program. The purpose of the intervention is to bring a change in the daily life of the patient and the family in order to improve disease control and quality of life. Aim: To standardize and apply a structured post-consultation model as part of multidisciplinary care in an educational program for asthmatic patients seen at the outpatient clinic of a public hospital, and to monitor the changes in asthma knowledge and quality of life. Methods: A longitudinal prospective study over six months with regular visits at four week intervals (total = 6 visits), conducted at the outpatient department of Unifesp/EPM/HSP, and the patients were included after signing a consent form. The asthma structured educational plan was conducted by a multidisciplinary team and addressed the following issues: what is asthma, relief and prevention medicines, daily report of symptoms and dyspnea score, training of the correct use of inhaled medication, discussion and actions regarding triggering factors and how to avoid them, and tips to recognize the signals of uncontrolled asthma. A standard questionnaire about general knowledge on asthma and a quality of life questionnaire were applied at the beginning, during the course, and at the end of the program. Results: 26 asthmatics were followed over six months and showed a statistically significant improvement in their identification and management of asthma skills as well as better quality of life indices. Conclusion: The model of care and the approach and training techniques were adequate and useful in the development of a structured educational program for socially deprived patients.


Epidemiology of asthma: it is necessary to expand our concepts

Epidemiologia da asma: é necessário ampliar nossos conceitos

Maria Alenita de Oliveira1,2,a

J Bras Pneumol.2018;44(5):341-342

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Torrington and Henderson and Epstein risk assessment scales: applicability and effectiveness in lung resection

Escalas de risco de Torrington e Henderson e de Epstein: aplicabilidade e efetividade nas ressecções pulmonares

Fabiana Stanzani, Maria Alenita de Oliveira, Vicente Forte, Sônia Maria Faresin

J Bras Pneumol.2005;31(4):292-299

Abstract PDF PT PDF EN Portuguese Text

Objective: To compare the incidences of pulmonary and cardiopulmonary postoperative complications estimated using, respectively, the scoring systems devised by Torrington and Henderson and by Epstein in a populational sample undergoing lung resection for the treatment of lung cancer. Methods: Prospective data from patients submitted to resection of one or more pulmonary lobes were selected from the databases of two tertiary-care hospitals. The outcome measures were pulmonary complications, cardiac complications and mortality rates. Fisher's exact test was used to evaluate the concordance between the predicted and observed complications. Results: The Torrington and Henderson scoring system was applied to 50 patients, in which the risk was found to be mild in 12, moderate in 32, and high in 6. Although accurately identifying patients at high risk, the Torrington and Henderson scale underestimated the rate of postoperative cardiopulmonary complications in the mild and moderate risk categories (p = 0.0003 and p = 0.0006, respectively). The Epstein scoring system was applied to 38 patients, 4 of which were found to be at high risk, and 34 of which were found to be at mild risk. The Epstein scale also underestimated the risk in the patients (the majority) that were classified as being at mild risk (p < 0.0001) and yet, like the Torrington and Henderson scale, accurately identified those at high risk. Conclusion: Neither of the two scoring systems analyzed were found to be appropriate for predicting the risk of pulmonary and cardiopulmonary complications in most cases.


Keywords: Postoperative complications; Preoperative care; Thoracic surgical procedures/mortality; Lung neoplasms/surgery; Pneumonectomy; Respiratory function tests; Risk factors; Risk assessment


2020 Brazilian Thoracic Association recommendations for the management of asthma

Recomendações para o manejo da asma da Sociedade Brasileira de Pneumologia e Tisiologia - 2020

Marcia Margaret Menezes Pizzichini1, Regina Maria de Carvalho-Pinto2, José Eduardo Delfini Cançado3, Adalberto Sperb Rubin,4,5, Alcindo Cerci Neto6,7, Alexandre Pinto Cardoso8, Alvaro Augusto Cruz9,10, Ana Luisa Godoy Fernandes11, Daniella Cavalet Blanco12, Elcio Oliveira Vianna13, Gediel Cordeiro Junior14,15, José Angelo Rizzo16, Leandro Genehr Fritscher12, Lilian Serrasqueiro Ballini Caetano11, Luiz Fernando Ferreira Pereira17, Marcelo Fouad Rabahi18, Maria Alenita de Oliveira19, Marina Andrade Lima20, Marina Buarque de Almeida21, Rafael Stelmach2, Paulo Márcio Pitrez22, Alberto Cukier2

J Bras Pneumol.2020;46(1):e20190307-e20190307

Abstract PDF PT PDF EN Portuguese Text

The pharmacological management of asthma has changed considerably in recent decades, as it has come to be understood that it is a complex, heterogeneous disease with different phenotypes and endotypes. It is now clear that the goal of asthma treatment should be to achieve and maintain control of the disease, as well as to minimize the risks (of exacerbations, disease instability, accelerated loss of lung function, and adverse treatment effects). That requires an approach that is personalized in terms of the pharmacological treatment, patient education, written action plan, training in correct inhaler use, and review of the inhaler technique at each office visit. A panel of 22 pulmonologists was invited to perform a critical review of recent evidence of pharmacological treatment of asthma and to prepare this set of recommendations, a treatment guide tailored to use in Brazil. The topics or questions related to the most significant changes in concepts, and consequently in the management of asthma in clinical practice, were chosen by a panel of experts. To formulate these recommendations, we asked each expert to perform a critical review of a topic or to respond to a question, on the basis of evidence in the literature. In a second phase, three experts discussed and structured all texts submitted by the others. That was followed by a third phase, in which all of the experts reviewed and discussed each recommendation. These recommendations, which are intended for physicians involved in the treatment of asthma, apply to asthma patients of all ages.


Keywords: Asthma/therapy; Asthma/drug therapy; Asthma/prevention & control; Practice guideline.




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