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

Kämpe M, Lisspers K, Ställberg B, Sundh J, Montgomery S, Janson C - Eur Clin Respir J (2014)

Bottom Line: Postal questionnaires were sent to 1,675 patients and the response rate was 71%.Older age and lower educational level remained statistically significantly associated with poorly controlled asthma when the analyses were limited to never-smokers.Uncontrolled asthma was significantly associated with lower quality of life.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical Sciences, Respiratory Medicine and Allergology, Uppsala University Uppsala, Sweden.

ABSTRACT

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.

No MeSH data available.


Related in: MedlinePlus

Asthma treatment steps. Step 1: only SABA on-demand. Step 2: ICS alone for maintenance and SABA on-demand. Step 3: ICS and LABA or leukotriene antagonists for maintenance and SABA on-demand.
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Figure 0003: Asthma treatment steps. Step 1: only SABA on-demand. Step 2: ICS alone for maintenance and SABA on-demand. Step 3: ICS and LABA or leukotriene antagonists for maintenance and SABA on-demand.

Mentions: In patients with controlled asthma, just over 40% were in receipt of rescue medication with short-acting β-agonist (SABA) alone and 58% received inhaled corticosteroids (ICS) alone or ICS in combination with long acting β-agonist (LABA) or leukotriene receptor agonists. In patients with uncontrolled asthma, 71% had regular treatment with ICS in combination with LABA or leukotriene receptor agonists and 19% received ICS as monotherapy for maintenance (Fig. 3).


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

Kämpe M, Lisspers K, Ställberg B, Sundh J, Montgomery S, Janson C - Eur Clin Respir J (2014)

Asthma treatment steps. Step 1: only SABA on-demand. Step 2: ICS alone for maintenance and SABA on-demand. Step 3: ICS and LABA or leukotriene antagonists for maintenance and SABA on-demand.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4629716&req=5

Figure 0003: Asthma treatment steps. Step 1: only SABA on-demand. Step 2: ICS alone for maintenance and SABA on-demand. Step 3: ICS and LABA or leukotriene antagonists for maintenance and SABA on-demand.
Mentions: In patients with controlled asthma, just over 40% were in receipt of rescue medication with short-acting β-agonist (SABA) alone and 58% received inhaled corticosteroids (ICS) alone or ICS in combination with long acting β-agonist (LABA) or leukotriene receptor agonists. In patients with uncontrolled asthma, 71% had regular treatment with ICS in combination with LABA or leukotriene receptor agonists and 19% received ICS as monotherapy for maintenance (Fig. 3).

Bottom Line: Postal questionnaires were sent to 1,675 patients and the response rate was 71%.Older age and lower educational level remained statistically significantly associated with poorly controlled asthma when the analyses were limited to never-smokers.Uncontrolled asthma was significantly associated with lower quality of life.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical Sciences, Respiratory Medicine and Allergology, Uppsala University Uppsala, Sweden.

ABSTRACT

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.

No MeSH data available.


Related in: MedlinePlus