Predictors of Poor Asthma Control in European Adults

Abstract

Asthmatics in the community suffer morbidity due to poor asthma control. The Global Initiative for Asthma (GINA) guidelines established minimum goals for the management of asthma. Our objective was to quantify the demographic and clinical factors associated with asthma control in adult asthmatics. A population sample of asthmatics 16 years and older was obtained by random digit dialing in seven European countries (France, Germany, Italy, The Netherlands, Spain, Sweden, and United Kingdom), and asthma control was quantified according to daytime and nighttime symptoms, severe episodes, and limits on daily activities due to asthma. Among the 2050 adult current asthmatics surveyed, 35% had good asthma control (0 or 1 GINA goals failed), 40% had moderate asthma control (2 or 3 GINA goals failed), and 25% had poor asthma control (4 or 5 GINA goals failed). Fewer subjects with poor than those with good asthma control had ever received a lung function test, and significantly fewer patients with poor asthma control had been taught by a doctor or nurse how to use their peak flow meter. When questioned about the underlying cause of asthma, only 7.8% of asthmatics mentioned airway inflammation, and only 17.6% stated that inhaled corticosteroids were the most effective medication for reducing airway inflammation. There was more use of quick relief bronchodilator medications in the past 4 weeks among patients with poor asthma control. Asthma management practices and the knowledge, attitudes, and behavior of adult asthmatics in the general population are associated with the degree of asthma control.

Development and validation of a questionnaire to assess asthma control in pediatrics

“…The Asthma Insights and Reality in Europe (AIRE) study, which assessed asthma control in an European population according to the GINA criteria, showed that currently asthma control in Europe falls far short of the objectives established by GINA. 4 The same study highlighted the particularly low level of asthma control in some countries. 4 The GINA document also recommended that local guidelines should be produced to take into account local treatment and health care needs, as well as resource requirements.…”

“…4 The same study highlighted the particularly low level of asthma control in some countries. 4 The GINA document also recommended that local guidelines should be produced to take into account local treatment and health care needs, as well as resource requirements. 3 With this in mind, various clinical guidelines for childhood asthma have recently been developed in different countries.…”

Factors associated with uncontrolled asthma in Porto Alegre, Brazil

“…Although this measure has not yet been validated, it simultaneously takes into account several markers of uncontrolled asthma (5). More recently, several studies have used this measure to evaluate asthma control (3)(4)(5)8,17).…”

“…In the past, a number of markers have been separately considered to define the health status of asthmatic subjects (5) and, more recently, to evaluate asthma control (3,5,8,17). In the present study, we used a composite measure of asthma control according to a scheme based on GINA guidelines (2).…”

“…Because asthma cannot currently be cured, the goal of asthma therapy is to attain asthma control (1). Asthma management guidelines, such as the Global Initiative for Asthma (GINA) (2), have been introduced to improve patient care and provide optimal long-term asthma control, thereby reducing the morbidity and mortality associated with the disease and the economic burden it entails (3).…”