Determinants of uncontrolled asthma in a Swedish asthma population: cross-sectional observational study

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Kämpe, Mary ; Lisspers, Karin ; Ställberg, Björn ; Sundh, Josefin ; Montgomery, Scott ; Janson, Christer (2014)

 Background: Asthma control is achieved in a low proportion of patients. The primary aim was to evaluate risk factors for uncontrolled asthma. The secondary aim was to assess quality of life associated with asthma control.Methods: In a cross-sectional study, asthma patients aged 18–75 were randomly selected from primary and secondary health care centers. Postal questionnaires were sent to 1,675 patients and the response rate was 71%. A total of 846 patients from primary and 341 patients from secondary care were evaluated. Data were collected using a questionnaire and review of medical records. The questionnaire included questions about asthma control and a quality-of-life questionnaire, the mini-AQLQ, with four domains (symptoms, activity limitation, emotional function, and environmental stimuli). The mean score for each domain and the overall score were calculated. Asthma control was divided into three levels according to the GINA guidelines and partly and uncontrolled asthma were combined into one group – poorly controlled asthma.Results: Asthma control was achieved in 36% of the sample: 38% in primary and 29% in secondary care. In primary and secondary care, 35 and 45% had uncontrolled asthma, respectively. Risk factors for poorly controlled asthma were female sex [OR 1.31 (1.003–1.70)], older age [OR 2.18 (1.28–3.73)], lower educational level [OR 1.63 (1.14–2.33)], and current smoking [OR 1.68 (1.16–2.43)]. Older age and lower educational level remained statistically significantly associated with poorly controlled asthma when the analyses were limited to never-smokers. Depression was an independent risk factor for poorly controlled asthma in men [OR 3.44 (1.12–10.54)]. The mini-AQLQ scores and the mean overall score were significantly lower in uncontrolled asthma.Conclusion: Risk factors for poorly controlled asthma were female sex, older age, low educational level, and smoking. Uncontrolled asthma was significantly associated with lower quality of life.Keywords: asthma; uncontrolled; risk factors; quality of life; cross-sectional study(Published: 12 September 2014)Citation: European Clinical Respiratory Journal 2014, 1: 24109 - http://dx.doi.org/10.3402/ecrj.v1.24109Responsible Editor: Charlotte Ulrik, University of Copenhagen, Denmark. 
  • References (42)
    42 references, page 1 of 5

    1. Accordini S, Corsico AG, Braggion M, Gerbase MW, Gislason D, Gulsvik A, et al. The cost of persistent asthma in Europe: an international population-based study in adults. Int Arch Allergy Immunol. 2013; 160: 93 101. doi: 10.1159/000338998.

    2. Global Initiative for Asthma (GINA). Global strategy for asthma management and prevention. NHLBI/WHO Report, updated 2013. Available from: www.ginasthma.org [cited 2014 January 24].

    3. O'Byrne PM, Reddel HK, Eriksson G, Ostlund O, Peterson S, Sears MR, et al. Measuring asthma control: a comparison of three classification systems. Eur Respir J. 2010; 36: 269 76. doi: 10.1183/09031936.00124009.

    4. National Asthma Education and Prevention Program (2007). Expert panel report III: guidelines for the diagnosis and management of asthma. Betheseda, MD: National Heart, Lung, and Blood Institute. NIH publication no. 08-4051.

    5. Cazzoletti L, Marcon A, Janson C, Corsico A, Jarvis D, Pin I, et al. Asthma control in Europe: a real-world evaluation based on an international population-based study. J Allergy Clin Immunol. 2007; 120: 1360 7.

    6. Peters SP, Jones CA, Haselkorn T, Mink DR, Valacer DJ, Weiss ST. Real-world evaluation of asthma control and treatment (REACT): findings from a national Web-based survey. J Allergy Clin Immunol. 2007; 119: 1454 61.

    7. Sta¨llberg B, Lisspers K, Hasselgren M, Janson C, Johansson G, Sva¨rdsudd K. Asthma control in primary care in Sweden: a comparison between 2001 and 2005. Prim Care Respir J. 2009; 18: 279 86. doi: 10.4104/pcrj.2009.00024.

    8. Carlstrom L, Castro M. Severe asthma: what makes it so hard to manage? Curr Allergy Asthma Rep. 2009; 9: 393 400.

    9. O'Byrne PM, Pedersen S, Schatz M, Thoren A, Ekholm E, Carlsson LG, et al. The poorly explored impact of uncontrolled asthma. Chest. 2013; 143: 511 23. doi: 10.1378/chest.12-0412. Review.

    10. Corsico AG, Cazzoletti L, de Marco R, Janson C, Jarvis D, Zoia MC, et al. Factors affecting adherence to asthma treatment in an international cohort of young and middle-aged adults. Respir Med. 2007; 101: 1363 7.

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