Factors related to poor asthma control in Latvian asthma patients between 2013 and 2015

The correlation between self-related adherence, asthma-related quality of life and control of asthma in adult patients

OBJECTIVES

Medication non-adherence mostly occurs in patients with a wide range of disease severity, including asthma. The aim of the study was to assess the self reported adherence to asthma therapy and investigate the relationship between adherence, asthma control and asthma-related quality of life.

METHODS

The study was a cross-sectional study in which participants were recruited from an outpatient department, in one hospital in Surabaya. Patients (aged≥18 years) with asthma who had used any regular asthma medications were included. Standardised questionnaires, including Juniper's Asthma Control Questionnaire (ACQ), Adherence to Refills and Medications Scales (ARMS) and Juniper's Asthma Quality of Life Questionnaire (AQLQ) were used.

RESULTS

A total of 82 adults with asthma were recruited in the study. Male participants' mean age was 49.13 ± 14.10 years (n = 23). Approximately 59 participants (72.0%) were females, 30 participants (36.5%) were using Budesonide inhaler, and 73 participants (89.0%) never smoked. The mean of ACQ, AQLQ, and ARMS scores were 1.62 ± 1.19, 4.96 ± 1.24, and 16.98 ± 4.12, respectively. Of 82 patients studied 53 (64.6 %) had "uncontrolled asthma" and more than 85% participants both showed "non adherence" to asthma therapy and nearly 46% of them indicated that their quality of life was affected by asthma. There was a significant association between ACQ and AQLQ (p<0.05), whereas no statistically significant association was found between ACQ and ARMS.

CONCLUSIONS

The majority of patients reported non-adherence to asthma medications. Poor controlled asthma has been associated with lower asthma-related quality of life.

The factors of family management affecting asthma control status in school-age children with asthma in China

OBJECTIVE

To identify the factors of family management affecting asthma control status in school-age children with asthma in China.

METHOD

The cross-sectional descriptive study was conducted among 139 children with asthma and their parents. The age range of the children was 7 to 14 years of age (M_age = 9.85; 76.26% boys). Eight dimensions (Children Identity, View of Condition, Management Mindset, Parental Mutuality, Parenting Philosophy, Management Approach, Family Focus, Future Expectation) of the Family Management Scale for Children with Asthma (FMSCA) were used as factors of family management. The Asthma Control Test (ACT) and the Children Asthma Control Test (C-ACT) were used to measure the asthma control status of children. A parental questionnaire was used to collect information regarding demographic data of familial socioeconomic status, general data about the child, and medical services status (Follow-Up Plan, received manual of asthma education, attended a lecture on asthma) received from medical institutions. A multivariate ordinal logistic regression model was performed.

RESULTS

Factors significantly associated with asthma control were "Follow-Up Plan" (OR, 2.004; 95% CI, 1.009-3.981), "Attended a Lecture on asthma" (OR, 2.586; 95% CI, 1.103-6.066) and two dimensions of the FMSCA, "Children Identity" (OR = 1.133; 95% CI, 1.024-1.254) and "Family Focus" (OR = 1.114; 95% CI, 1.007-1.232).

CONCLUSION

This study shows that asthma control status of school-age children in China is related to the parents' views of their child as having a "normal condition" and the parents' satisfaction with the balance between asthma related management and other aspects of family life.

A multinational observational study identifying primary care patients at risk of overestimation of asthma control

Factors related to the discrepancy between patient-perceived and actual disease control remain unclear. Identifying patients at risk of overestimation of asthma control remains elusive. This study aimed to (i) investigate the relationship between patient-reported and actual level of asthma control (ii), compare the characteristics between patients who believe their asthma is well controlled that accurately report ‘well-controlled’ asthma with those that do not, and (iii) identify factors associated with inaccurately reported ‘well-controlled’ asthma. A historical, multinational, cross-sectional study using data from the iHARP (initiative Helping Asthma in Real-life Patients) review service for adults with asthma prescribed fixed-dose combination therapy. Data from 4274 patients were analysed. A major discrepancy between patient-reported and Global Initiative for Asthma defined asthma control was detected; 71.1% of patients who reported ‘well-controlled’ asthma were inaccurate in their perception despite receiving regular maintenance therapy. Significant differences were noted in age, gender, body mass index, education level, medication use, side effects, attitudes to preventer inhaler use, inhaler technique review and respiratory specialist review between patients who accurately reported ‘well-controlled’ asthma and those who did not. Independent risk factors associated with inaccurately reported ‘well-controlled’ asthma were: having taken a maximum of 5–12 puffs or more of reliever inhaler on at least one day within the previous 4 weeks; being female; having seen a respiratory specialist more than a year ago (rather than in the previous year); and having required oral corticosteroids for worsening asthma in the previous year. The study highlighted the significant hidden burden associated with under-recognition of poor asthma control, on the part of the patient and the need for targeted interventions designed to address the continuing discrepancy between perceived and actual disease control.