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The effect of the COVID-19 pandemic on severe asthma care in Europe - will care change for good?

Katrien Eger, Dora Paroczai, Alison Bacon, Florence Schleich, Svetlana Sergejeva, Arnaud Bourdin, Isabelle Vachier, Eleftherios Zervas, Konstantinos Katsoulis, Dimosthenis Papapetrou, Konstantinos Kostikas, Zsuzsanna Csoma, Henrico Heffler, Goergio Watler Canonica, Ineta Grisle, Kristina Bieksiene, Jolita Palacionyte, Anneke ten Brinke, Simone Hashimoto, Frank WJM Smeenk, Gert-Jan Braunstahl, Simone van der Sar, Florin Mihălţan, Natalia Nenasheva, Marina Peredelskaya, Biljana Zvezdin, Ivan Čekerevac, Sanja Hromiš, Vojislav Ćupurdija, Zorica Lazic, Branislava Milenkovic, Sanja Dimic-Janjic, Valentyna Yasinska, Barbro Dahlén, Apostolos Bossios, Nikolaos Lazarinis, David Aronsson, Arne Egesten, Abul Kashem Mohammad Munir, Lars Ahlbeck, Christer Janson, Sabina Škrgat, Natalija Edelbaher, Joerg Leuppi, Fabienne Jaun, Jochen Rüdiger, Nikolay Pavlov, Pietro Gianella, Reta Fischer, Florian Charbonnier, Rekha Chaudhuri, Steven James Smith, Simon Doe, Michelle Fawdon, Matthew Masoli, Liam Heaney, Hans Michael Haitchi, Ramesh Kurukulaaratchy, Olivia Fulton, Betty Frankemölle, Toni Gibson, Karen Needham, Peter Howarth, Ratko Djukanovic, Elisabeth Bel, Michael Hyland
ERJ Open Research 2022; DOI: 10.1183/23120541.00065-2022
Katrien Eger
1Academic Medical Centre, University of Amsterdam, Amsterdam, Netherlands
46co-first authors
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  • For correspondence: k.a.eger@amsterdamumc.nl
Dora Paroczai
2Csongrad County Hospital and the Department of Pulmonology, University of Szeged, Szeged, Hungary
46co-first authors
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Alison Bacon
42School of Psychology, University of Plymouth, Plymouth, United Kingdom
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Florence Schleich
3CHU of Liege, Liege, Belgium
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Svetlana Sergejeva
4The North Estonian medical Centre, Tallinn, Estonia
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Arnaud Bourdin
5PhyMedExp, CHU Montpellier, University of Montpellier, Montpellier, France
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  • ORCID record for Arnaud Bourdin
Isabelle Vachier
5PhyMedExp, CHU Montpellier, University of Montpellier, Montpellier, France
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Eleftherios Zervas
67th Respiratory Department, Athens Chest Hospital, Athens, Greece
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Konstantinos Katsoulis
7Pulmonary Department, 424 Army General Hospital, Thessaloniki, Greece
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Dimosthenis Papapetrou
8Medical Group of Athens (Paleo Faliro Clinic), Athens, Greece
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Konstantinos Kostikas
9Respiratory Medicine Department, University Hospital of Ioannina, Ioannina, Greece
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Zsuzsanna Csoma
10National Koranyi Institute for Pulmonology, Budapest, Hungary
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Henrico Heffler
11Humanitas University, Milan, Italy
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Goergio Watler Canonica
11Humanitas University, Milan, Italy
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Ineta Grisle
12Riga East University Hospital, Riga, Latvia
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Kristina Bieksiene
13Lithuanian University of Health Science, Kaunas, Lithuania
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Jolita Palacionyte
13Lithuanian University of Health Science, Kaunas, Lithuania
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Anneke ten Brinke
14Medical Centre Leeuwarden, Leeuwarden, Netherlands
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Simone Hashimoto
1Academic Medical Centre, University of Amsterdam, Amsterdam, Netherlands
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Frank WJM Smeenk
15Catharina Ziekenhuis Eindhoven, Eindhoven, Netherlands
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Gert-Jan Braunstahl
16Franciscus Gasthuis & Vlietland, Rotterdam, Netherlands
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Simone van der Sar
17Amphia ziekenhuis, Breda, Netherlands
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Florin Mihălţan
18National Institute of Pneumology
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Natalia Nenasheva
19Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russian Federation, Moskva, Russian Federation
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Marina Peredelskaya
19Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russian Federation, Moskva, Russian Federation
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Biljana Zvezdin
20Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia
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Ivan Čekerevac
21Medical Faculty Novi Sad, University of Novi Sad, Bucharest, Romania
23Clinic for Pulmonology, University Clinical Center Kragujevac, Kragujevac, Serbia
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Sanja Hromiš
20Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia
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Vojislav Ćupurdija
21Medical Faculty Novi Sad, University of Novi Sad, Bucharest, Romania
23Clinic for Pulmonology, University Clinical Center Kragujevac, Kragujevac, Serbia
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Zorica Lazic
21Medical Faculty Novi Sad, University of Novi Sad, Bucharest, Romania
23Clinic for Pulmonology, University Clinical Center Kragujevac, Kragujevac, Serbia
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Branislava Milenkovic
24Clinic for Pulmonology, University Clinical Center of Serbia, Belgrade Medical faculty, Beograd, Serbia
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Sanja Dimic-Janjic
24Clinic for Pulmonology, University Clinical Center of Serbia, Belgrade Medical faculty, Beograd, Serbia
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Valentyna Yasinska
25Karolinska Severe Asthma Center, Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Huddinge and Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
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Barbro Dahlén
25Karolinska Severe Asthma Center, Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Huddinge and Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
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Apostolos Bossios
25Karolinska Severe Asthma Center, Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Huddinge and Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
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Nikolaos Lazarinis
25Karolinska Severe Asthma Center, Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Huddinge and Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
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David Aronsson
26Respiratory Medicine and Allergology, Department of Clinical Sciences Lund, Lund University and Skåne University Hospital, Lund, Sweden
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Arne Egesten
26Respiratory Medicine and Allergology, Department of Clinical Sciences Lund, Lund University and Skåne University Hospital, Lund, Sweden
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Abul Kashem Mohammad Munir
26Respiratory Medicine and Allergology, Department of Clinical Sciences Lund, Lund University and Skåne University Hospital, Lund, Sweden
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Lars Ahlbeck
27Allergy center, Linköping, Sweden
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Christer Janson
28Department of Medical Sciences, Uppsala University, Uppsala, Sweden
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Sabina Škrgat
29Department for Pulmonary Diseases, University Medical Centre Ljubljana, Medical faculty, University of Ljubljana, Ljubljana, Slovenia
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Natalija Edelbaher
30Pulmonary Department, University Medical Centre Maribor, Maribor, Slovenia
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Joerg Leuppi
31Medical Faculty University of Basel and Cantonal Hospital Baselland, Liestal, Switzerland
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Fabienne Jaun
31Medical Faculty University of Basel and Cantonal Hospital Baselland, Liestal, Switzerland
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Jochen Rüdiger
32Medizin Stollturm, Basel, Switzerland
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Nikolay Pavlov
33Department of Pulmonary Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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Pietro Gianella
34EOC Lugano, Lugano, Switzerland
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Reta Fischer
35Quartier Bleu, Bern, Switzerland
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Florian Charbonnier
36HUG Geneve, Geneve, Switzerland
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Rekha Chaudhuri
37Gartnavel General Hospital, Glasgow, Scotland
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Steven James Smith
37Gartnavel General Hospital, Glasgow, Scotland
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Simon Doe
38Royal Victoria infirmary, Newcastle, United Kingdom
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Michelle Fawdon
38Royal Victoria infirmary, Newcastle, United Kingdom
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Matthew Masoli
39The Royal Devon & Exeter Hospital
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Liam Heaney
40Wellcome-Wolfson Centre for Experimental Medicine, Queens University Belfast, Belfast, United Kingdom
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Hans Michael Haitchi
43University Hospital Southampton, Southampton, United Kingdom
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Ramesh Kurukulaaratchy
43University Hospital Southampton, Southampton, United Kingdom
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Olivia Fulton
44European Lung Foundation, Patient Advisory Group, Sheffield, United Kingdom
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Betty Frankemölle
44European Lung Foundation, Patient Advisory Group, Sheffield, United Kingdom
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Toni Gibson
44European Lung Foundation, Patient Advisory Group, Sheffield, United Kingdom
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Karen Needham
44European Lung Foundation, Patient Advisory Group, Sheffield, United Kingdom
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Peter Howarth
45Global Medical Affairs, Specialty Medicine TA, GSK, Brentford, Middlesex, United Kingdom
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Ratko Djukanovic
43University Hospital Southampton, Southampton, United Kingdom
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Elisabeth Bel
1Academic Medical Centre, University of Amsterdam, Amsterdam, Netherlands
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Michael Hyland
41Plymouth Marjon University, Plymouth, United Kingdom
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Abstract

Background The COVID-19 pandemic has put pressure on health-care services forcing the reorganisation of traditional care pathways. We investigated how physicians taking care of severe asthma patients in Europe reorganised care, and how these changes affected patient satisfaction, asthma control and future care.

Methods In this European-wide cross-sectional study, patient surveys were sent to patients with a physician-diagnosis of severe asthma, and physician surveys to severe asthma specialists between November 2020 and May 2021.

Results 1101 patients and 268 physicians from 16 European countries contributed to the study. Common physician-reported changes in severe asthma care included use of video/phone consultations (46%), reduced availability of physicians (43%) and change to home-administered biologics (38%). Change to phone/video consultations was reported in 45% of patients, of whom 79% were satisfied or very satisfied with this change. Of 709 patients on biologics, 24% experienced changes in biologic care, of whom 92% were changed to home-administered biologics and of these 62% were satisfied or very satisfied with this change. Only 2% reported worsening asthma symptoms associated with changes in biologic care. Many physicians expect continued implementation of video/phone consultations (41%) and home administration of biologics (52%).

Conclusions Change to video/phone consultations and home administration of biologics was common in severe asthma care during the COVID-19 pandemic, and was associated with high satisfaction levels in most but not all cases. Many physicians expect these changes to continue in future severe asthma care, though satisfaction levels may change after the pandemic.

Footnotes

This manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.

Jochen Rüdiger reports receiving payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from the Education of swiss Emergency physicians. Participation on a Data Safety Monitoring Board or Advisory Board for Boehringer Ingelheim. Member of the Board of the Swiss Society of Pneumology and President Thorax section of the Swiss Ultrasound Society. All disclosures made outside the submitted work.

Sabina Škrgat reports receiving honoraria for lectures and educational events, supported by GSK, Astra Zeneca, Sanofi, Chiesi, Pliva Teva and Medis. Participation on Advisory boards of GSK, Astra Zeneca, Chiesi and Sanofi. All disclosures made outside the submitted work.

Simon Doe reports receiving support for attending meetings and/or travel from GSK and Sanofi, outside the submitted work.

Simone van der Sar – van der Brugge reports receiving payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from AstraZeneca and GSK, Support received from ALK for attending meetings and/or travel. All disclosures made outside the submitted work.

Dr Steven J Smith is Supported by the Innovative Medicines Initiative 2 Joint Undertaking (JU) under grant agreement No. 831434 for Taxonomy, Targets, Treatment, and Remission. The JU receives support from the European Union's Horizon 2020 research and innovation program and the European Federation of Pharmaceutical Industries and Associates. All disclosures made outside the submitted work.

Zsuzsanna Csoma reports receiving honoraria for presentations: Astra/Zeneca, TEVA, Sanofi/Aventis (Hungary), outside the submitted work.

Apostolos Bossios reports receiving payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from AZ, GSK, TEVA. Support for attending meetings and/or travel received from NOVARTIS. Participation on a Data Safety Monitoring Board or Advisory Board for AZ, GSK, NOVARTIS, TEVA, SANOFI. Member of the steering Committee of SHARP, Secretary of Assembly 5 (Airway diseases, asthma, COPD and chronic cough), European Respiratory Society; vice-chair of Nordic Severe Asthma Network (NSAN). All disclosures made outside the submitted work.

Arnaud Bourdin reports receiving grants or contracts outside the submitted work from Astra Zeneca and Boeringher Ingelheim. Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events as well as support for attending meetings and/or travel from Astra Zeneca, Boeringher Ingelheim, GSK, Novartis, Chiesi and Amgen, outside the submitted work.

Arne Egesten reports receiving honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from AstraZeneca, outside the submitted work.

David Aronsson reports receiving grants or contracts from ALK-Abello, outside the submitted work.

Elisabeth H. Bel reports support for the present manuscript from ERS. Grants or contracts received from GlaxoSmithKline and Teva, outside the submitted work. Consulting fees received from AstraZeneca, GlaxoSmithKline, Sanofi, Sterna and Chiesi, outside the submitted work. Honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events received from Teva. Participation on a Data Safety Monitoring Board or Advisory Board for AstraZeneca, outside the submitted work. Leadership or fiduciary role in other board, society, committee or advocacy group, unpaid for SHARP-CRC and RAPSODI (Dutch registry), outside the submitted work.

Enrico Heffler reports receiving payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from AstraZeneca; Sanofi-Genzyme; Regeneron; Novartis; GSK; Circassia; Stallergenes-Greer; Nestlè Purina, outside the submitted work.

Florian Charbonnier reports receiving payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Sanofi, Novartis, Mundipharma, AstraZeneca, and GSK. Participation on a Data Safety Monitoring Board or Advisory Board for Sanofi, Novartis, Mundipharma, AstraZeneca, and GSK. All disclosures made outside the submitted work.

Giorgio Walter CANONICA reports receiving consulting fees from AstraZeneca GSK, Novartis, Sanofi, and Stallergenes Greer. Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from AstraZeneca, GSK, Novartis, Sanofi, Stallergenes Greer, Menarini, Chiesi, and Mylan. Participation on a Data Safety Monitoring Board or Advisory Board for AstraZeneca, GSK, Novartis, Sanofi, Stallergenes Greer, and Chiesi. All disclosures made outside the submitted work.

Gert-Jan Braunstahl reports grants or contracts from GSK, AstraZeneca, and ALK Abello. Consulting fees from GSK, Sanofi, ALK Abello, AstraZeneca, and Novartis. Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from GSK, Sanofi, ALK Abello, AstraZeneca, and Novartis. Leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid: Scientific board Dutch Lung Foundation, Task force Asthma NVALT, editorial board NTVAAKI. All disclosures made outside the submitted work.

Pietro Gianella reports participation on Advisory board Novartis about Xolair for Nasal polyps, outside the submitted work.

Lars Ahlbeck reports receiving payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from AstraZeneca. Participation on a Data Safety Monitoring Board or Advisory Board for AstraZeneca, Sanofi, and GSK. All disclosures made outside the submitted work.

Liam Heaney reports grants or contracts from Medimmune, Novartis UK, Roche/Genentech Inc, and Glaxo Smith Kline, Amgen, Genentech / Hoffman la Roche, Astra Zeneca, Medimmune, Glaxo Smith Kline, Aerocrine and Vitalograph. Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events for Novartis, Hoffman la Roche/Genentech Inc, Sanofi, Glaxo Smith Kline, Astra Zeneca, Teva and Circassia. Support for attending meetings and/or travel from AstraZeneca, Boehringer Ingelheim, Chiesi, GSK and Napp Pharmaceuticals. Participation on a Data Safety Monitoring Board or Advisory Board for Novartis, Hoffman la Roche/Genentech Inc, Sanofi, Evelo Biosciences, Glaxo Smith Kline, AstraZeneca, Teva, Theravance, and Circassia. All disclosures made outside the submitted work.

Matthew Masoli reports receiving grants or contracts from ERS SHARP to support the study ‘The burden of severe asthma on HRQoL across Europe’, outside the submitted work.

Michael Hyland reports receiving grants or contracts from TEVA. Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events for GSK. All disclosures made outside the submitted work.

Natalia Nenasheva reports receiving payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from AstraZeneca plc., Sanofi S.A., Teva Pharmaceuticals, Novartis International AG, and Chiesi Farmaceutici S.p.A., outside the submitted work.

Natalija Edelbaher reports receiving payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from GSK, Astra Zeneca, Chiesi, Pliva Teva, Krka, Novartis, Boehringer Ingelheim, and Sanofi. The author reports participation on Advisory boards of GSK, Astra Zeneca, Chiesi, Novartis, and Boehringer Ingelheim. All disclosures made outside the submitted work.

Nikolay Pavlov reports receiving payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from GSK, Novartis, and OM Pharma. Support for attending meetings and/or travel received from Boehringer Ingelheim. Participation on a Data Safety Monitoring Board or Advisory Board for AstraZeneca, GSK, Novartis, and Sanofi. All disclosures made outside the submitted work.

Peter Howarth reports to be employed by GSK.

Ratko Djukanovic reports support for the present manuscript received from ERS, TEVA, GSK, Novartis, Sanofi, and Chiesi. Consulting fees from Synairgen for which the author is a co-founder and consultant and owns shares, outside the submitted work. Participation on a Data Safety Monitoring Board or Advisory Board for Kymab (Cambridge), outside the submitted work.

Rekha Chaudhuri reports receiving grants or contracts from AstraZeneca. Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events for GSK, AstraZeneca, Teva, Chiesi, Sanofi, and Novartis. Support for attending meetings and/or travel received from Chiesi, Napp, Sanofi, Boehringer, GSK, and AZ. Participation on a Data Safety Monitoring Board or Advisory Board for GSK, AstraZeneca, Teva, Chiesi, and Novartis. All disclosures made outside the submitted work.

The remaining authors have nothing to disclose.

This is a PDF-only article. Please click on the PDF link above to read it.

  • Received February 2, 2022.
  • Accepted March 9, 2022.
  • Copyright ©The authors 2022
http://creativecommons.org/licenses/by-nc/4.0/

This version is distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0. For commercial reproduction rights and permissions contact permissions{at}ersnet.org

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The effect of the COVID-19 pandemic on severe asthma care in Europe - will care change for good?
Katrien Eger, Dora Paroczai, Alison Bacon, Florence Schleich, Svetlana Sergejeva, Arnaud Bourdin, Isabelle Vachier, Eleftherios Zervas, Konstantinos Katsoulis, Dimosthenis Papapetrou, Konstantinos Kostikas, Zsuzsanna Csoma, Henrico Heffler, Goergio Watler Canonica, Ineta Grisle, Kristina Bieksiene, Jolita Palacionyte, Anneke ten Brinke, Simone Hashimoto, Frank WJM Smeenk, Gert-Jan Braunstahl, Simone van der Sar, Florin Mihălţan, Natalia Nenasheva, Marina Peredelskaya, Biljana Zvezdin, Ivan Čekerevac, Sanja Hromiš, Vojislav Ćupurdija, Zorica Lazic, Branislava Milenkovic, Sanja Dimic-Janjic, Valentyna Yasinska, Barbro Dahlén, Apostolos Bossios, Nikolaos Lazarinis, David Aronsson, Arne Egesten, Abul Kashem Mohammad Munir, Lars Ahlbeck, Christer Janson, Sabina Škrgat, Natalija Edelbaher, Joerg Leuppi, Fabienne Jaun, Jochen Rüdiger, Nikolay Pavlov, Pietro Gianella, Reta Fischer, Florian Charbonnier, Rekha Chaudhuri, Steven James Smith, Simon Doe, Michelle Fawdon, Matthew Masoli, Liam Heaney, Hans Michael Haitchi, Ramesh Kurukulaaratchy, Olivia Fulton, Betty Frankemölle, Toni Gibson, Karen Needham, Peter Howarth, Ratko Djukanovic, Elisabeth Bel, Michael Hyland
ERJ Open Research Jan 2022, 00065-2022; DOI: 10.1183/23120541.00065-2022

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The effect of the COVID-19 pandemic on severe asthma care in Europe - will care change for good?
Katrien Eger, Dora Paroczai, Alison Bacon, Florence Schleich, Svetlana Sergejeva, Arnaud Bourdin, Isabelle Vachier, Eleftherios Zervas, Konstantinos Katsoulis, Dimosthenis Papapetrou, Konstantinos Kostikas, Zsuzsanna Csoma, Henrico Heffler, Goergio Watler Canonica, Ineta Grisle, Kristina Bieksiene, Jolita Palacionyte, Anneke ten Brinke, Simone Hashimoto, Frank WJM Smeenk, Gert-Jan Braunstahl, Simone van der Sar, Florin Mihălţan, Natalia Nenasheva, Marina Peredelskaya, Biljana Zvezdin, Ivan Čekerevac, Sanja Hromiš, Vojislav Ćupurdija, Zorica Lazic, Branislava Milenkovic, Sanja Dimic-Janjic, Valentyna Yasinska, Barbro Dahlén, Apostolos Bossios, Nikolaos Lazarinis, David Aronsson, Arne Egesten, Abul Kashem Mohammad Munir, Lars Ahlbeck, Christer Janson, Sabina Škrgat, Natalija Edelbaher, Joerg Leuppi, Fabienne Jaun, Jochen Rüdiger, Nikolay Pavlov, Pietro Gianella, Reta Fischer, Florian Charbonnier, Rekha Chaudhuri, Steven James Smith, Simon Doe, Michelle Fawdon, Matthew Masoli, Liam Heaney, Hans Michael Haitchi, Ramesh Kurukulaaratchy, Olivia Fulton, Betty Frankemölle, Toni Gibson, Karen Needham, Peter Howarth, Ratko Djukanovic, Elisabeth Bel, Michael Hyland
ERJ Open Research Jan 2022, 00065-2022; DOI: 10.1183/23120541.00065-2022
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