Prevalence and Risk Factors of Uncontrolled Asthma among Adults in a South Indian Tertiary Care Hospital

Abstract

BACKGROUND Globally, around 300 million people suffer from Bronchial asthma, the prevalence of which is predicted to increase in the ensuing decades. Prevalence rates range from 4-18% worldwide with around 2.05-3.5% reported in India. In spite of availability of updated guidelines from GINA & recent therapeutic advances, asthma control is still not being achieved in a significant proportion of patients. Uncontrolled asthma is associated with greater exacerbations, poorer quality of life & higher mortality which lead to considerable socioeconomic burden and emotional stress for patients and their families. The complex interaction of several variables including patient and disease related factors play a role in poor asthma control. Limited Indian studies especially in the South are available to assess the prevalence and risk factors of uncontrolled asthma. Hence, the present study was undertaken to enable recognition of modifiable risk factors in uncontrolled asthma which could serve as a platform to plan suitable interventions to achieve optimum asthma control. We wanted to estimate the prevalence of uncontrolled asthma among adult asthma patients and assess the risk factors associated with uncontrolled asthma. METHODS This is a cross sectional observational study. Adults with a diagnosis of asthma (Global Initiative of Asthma-GINA guidelines) for a duration of at least 1 year were administered validated & piloted questionnaire by telephonic interview or physical visit to assess demographic data, risk factors & level of control of asthma. Data was analysed using SPSS 20.0. Quantitative data expressed in Mean & SD. Unpaired T test & Chi square test to assess association of continuous & dichotomous variables. RESULTS A total of 110 asthmatics (M:F=59:51) with a mean age 35.25 ± 12.34 years and mean BMI 25.75 ± 3.80 were included in the study. Well controlled, partly controlled and uncontrolled asthma were 11.8%, 39.1% & 49.1% respectively. Risk factors associated with uncontrolled asthma were elderly, obesity, smoking, pollution & GERD. CONCLUSIONS Asthma control in the majority was uncontrolled. Increasing age, obesity, smoking & GERD were risk factors significantly associated with poor asthma control.