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Multicenter Study
. 2004 Jan;92(1):32-9.
doi: 10.1016/S1081-1206(10)61707-3.

Design and Baseline Characteristics of the Epidemiology and Natural History of Asthma: Outcomes and Treatment Regimens (TENOR) Study: A Large Cohort of Patients With Severe or Difficult-To-Treat Asthma

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Multicenter Study

Design and Baseline Characteristics of the Epidemiology and Natural History of Asthma: Outcomes and Treatment Regimens (TENOR) Study: A Large Cohort of Patients With Severe or Difficult-To-Treat Asthma

Chantal M Dolan et al. Ann Allergy Asthma Immunol. .

Abstract

Background: Patients with severe and difficult-to-treat asthma represent a small percentage of asthma patients, yet they account for much of the morbidity, mortality, and cost of disease. The goal of The Epidemiology and Natural History of Asthma: Outcomes and Treatment Regimens (TENOR) study is to better understand the natural history of asthma in these patients.

Objective: To describe the methods and baseline characteristics of the TENOR study cohort.

Methods: The TENOR study is a 3-year, multicenter, observational study of patients with severe or difficult-to-treat asthma. From January through October 2001, more than 400 US pulmonologists and allergists enrolled patients. Patients 6 years or older who were considered to have severe or difficult-to-treat asthma by their physicians were eligible. Patients have been receiving care for 1 year or more, have a smoking history of 30 pack-years or less, and have current high medication or health care utilization in the past year. Data are collected semiannually.

Results: A total of 4,756 patients enrolled and completed a baseline visit. Overall, 73% of the TENOR study patients are adults, 10% are adolescents, and 16% are children. According to physician evaluation, 48% of patients have severe asthma, 48% have moderate asthma, 3% have mild asthma, and 96% have difficult-to-treat asthma. Severe asthmatic patients have the highest health care utilization in the past 3 months (P < .001).

Conclusions: The TENOR study is the largest cohort of patients with severe or difficult-to-treat asthma. Although patients are equally divided into moderate or severe asthma categories, most are considered difficult-to-treat. The TENOR study highlights the lack of control in moderate-to-severe asthma and provides a unique opportunity to examine factors related to health outcomes in this understudied population.

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