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      Burden of Respiratory Disease in Korea: An Observational Study on Allergic Rhinitis, Asthma, COPD, and Rhinosinusitis

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          Abstract

          Purpose

          The Asia-Pacific Burden of Respiratory Diseases (APBORD) study is a cross-sectional, observational one which has used a standard protocol to examine the disease and economic burden of allergic rhinitis (AR), asthma, chronic obstructive pulmonary disorder (COPD), and rhinosinusitis across the Asia-Pacific region. Here, we report on symptoms, healthcare resource use, work impairment, and associated costs in Korea.

          Methods

          Consecutive participants aged ≥18 years with a primary diagnosis of asthma, AR, COPD, or rhinosinusitis were enrolled. Participants and their treating physician completed a survey detailing respiratory symptoms, healthcare resource use, and work productivity and activity impairment. Costs included direct medical cost and indirect cost associated with lost work productivity.

          Results

          The study enrolled 999 patients. Patients were often diagnosed with multiple respiratory disorders (42.8%), with asthma/AR and AR/rhinosinusitis the most frequently diagnosed combinations. Cough or coughing up phlegm was the primary reason for the medical visit in patients with a primary diagnosis of asthma and COPD, whereas nasal symptoms (watery runny nose, blocked nose, and congestion) were the main reasons in those with AR and rhinosinusitis. The mean annual cost for patients with a respiratory disease was US$8,853 (SD 11,245) per patient. Lost productivity due to presenteeism was the biggest contributor to costs.

          Conclusions

          Respiratory disease has a significant impact on disease burden in Korea. Treatment strategies for preventing lost work productivity could greatly reduce the economic burden of respiratory disease.

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          Most cited references23

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          International statistical classification of diseases and related health problems

          GR Brämer (2010)
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            European position paper on rhinosinusitis and nasal polyps 2007.

            Rhinosinusitis is a significant and increasing health problem which results in a large financial burden on society. This evidence based position paper describes what is known about rhinosinusitis and nasal polyps, offers evidence based recommendations on diagnosis and treatment, and considers how we can make progress with research in this area. Rhinitis and sinusitis usually coexist and are concurrent in most individuals; thus, the correct terminology is now rhinosinusitis. Rhinosinusitis (including nasal polyps) is defined as inflammation of the nose and the paranasal sinuses characterised by two or more symptoms, one of which should be either nasal blockage/obstruction/congestion or nasal discharge (anterior/posterior nasal drip), +/- facial pain/pressure, +/- reduction or loss of smell; and either endoscopic signs of polyps and/or mucopurulent discharge primarily from middle meatus and/or; oedema/mucosal obstruction primarily in middle meatus, and/or CT changes showing mucosal changes within the ostiomeatal complex and/or sinuses. The paper gives different definitions for epidemiology, first line and second line treatment and for research. Furthermore the paper describes the anatomy and (patho)physiology, epidemiology and predisposing factors, inflammatory mechanisms, evidence based diagnosis, medical and surgical treatment in acute and chronic rhinosinusitis and nasal polyposis in adults and children. Evidence based schemes for diagnosis and treatment are given for the first and second line clinicians. Moreover attention is given to complications and socio-economic cost of chronic rhinosinusitis and nasal polyps. Last but not least the relation to the lower airways is discussed.
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              Epidemiology of adult asthma in Asia: toward a better understanding

              Asia is the world's most dynamic area. Asthma is a major chronic disease in Asia, like other continents. However, unlike childhood asthma, the epidemiological burden of asthma in Asian adults has been unclear. Here we reviewed the currently available literatures on the epidemiology of adult asthma in the Asian community populations. Adult asthma prevalence was generally lower in Asian than in Europe, but the increasing trends suggested the disease burden to rise in the near future. However, for better understanding, it may be essential to prepare for the Asian multinational network for the standardization and collaboration of research.
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                Author and article information

                Journal
                Allergy Asthma Immunol Res
                Allergy Asthma Immunol Res
                AAIR
                Allergy, Asthma & Immunology Research
                The Korean Academy of Asthma, Allergy and Clinical Immunology; The Korean Academy of Pediatric Allergy and Respiratory Disease
                2092-7355
                2092-7363
                November 2016
                16 August 2016
                : 8
                : 6
                : 527-534
                Affiliations
                [1 ]Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
                [2 ]Dami IM Clinic, Seoul, Korea.
                [3 ]Seoulbom IM Clinic, Seoul, Korea.
                [4 ]Jong-Woong Kim IM Clinic, Seoul, Korea.
                [5 ]Hamchun Medical Clinic, Incheon, Korea.
                [6 ]Coco ENT Clinic, Seoul, Korea.
                [7 ]Myung ENT Clinic, Seoul, Korea.
                [8 ]National Allergy Asthma Bronchitis Institute, Kolkata, India.
                [9 ]Institute of Respiratory Medicine, Kuala Lumpur, Malaysia.
                [10 ]Division of Thoracic Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
                [11 ]Department of Otorhinolaryngology, Khon Kaen University, Khon Kaen, Thailand.
                [12 ]Merck & Co., Inc., Kenilworth, NJ, USA.
                [13 ]Merck & Co., Inc. (retired), Kenilworth, NJ, USA.
                [14 ]Optum, Sydney, Australia.
                [15 ]Department of Otolaryngology, National University of Singapore, Singapore, Singapore.
                [16 ]Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
                Author notes
                Correspondence to: Sang-Heon Cho, MD, PhD, Division of Asthma, Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea. Tel: +82-2-2072-2971; Fax: +82-2-742-3291; shcho@ 123456snu.ac.kr
                Article
                10.4168/aair.2016.8.6.527
                5011053
                27582404
                296987d7-98f5-4b9b-90ee-5febf2e8a716
                Copyright © 2016 The Korean Academy of Asthma, Allergy and Clinical Immunology • The Korean Academy of Pediatric Allergy and Respiratory Disease

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 06 January 2016
                : 23 May 2016
                : 03 June 2016
                Funding
                Funded by: Merck & Co., Inc., CrossRef http://dx.doi.org/10.13039/100004334;
                Categories
                Original Article

                Immunology
                respiratory tract disease,cost of illness,health care costs,korea
                Immunology
                respiratory tract disease, cost of illness, health care costs, korea

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