Suboptimal asthma control: prevalence, detection and consequences in general practice

Abstract

Telephone surveys describing suboptimal asthma control may be biased by low response rates.In order to obtain an unbiased assessment of asthma control and assess its impact in primary care, primary care physicians used a 1-page control questionnaire in 50 consecutive asthma patients.Of the 10,428 patients assessed by 354 physicians, 59% were uncontrolled, 19% well-controlled and 23% totally controlled. Physicians overestimated control, regarding only 42% of patients as uncontrolled. Physicians were more likely to report plans to alter the regimens of uncontrolled patients than controlled patients (1.29 versus 0.20 medication changes per patient) doing so in a fashion consistent with guideline recommendations. Of the uncontrolled patients, 59% required one or more urgent care or specialist visits versus 26 and 15% of well-controlled or totally controlled patients, respectively. Patients were more likely to report short-term symptom control when they had not required urgent or specialist care (odds ratio 5.68; 95% confidence interval 4.91-6.58).The majority of asthma patients treated in general practice are uncontrolled. Lack of control can be recognised by physicians who are likely to consider appropriate changes to therapy. A lack of short-term symptom control of asthma is associated with excess healthcare utilisation.

Asthma-related comorbidities

“…In poorly controlled asthma, the use of systemic corticosteroids, reduction of activities and exercise, and possibly poor sleep quality, can all contribute to obesity, diabetes and depression. Oral corticosteroids may predispose to glucose intolerance/diabetes, in addition to osteoporosis, increased fracture risk and pneumonia [197].…”

Asthma Prevalence and Risk Factors Analysis in Tricity University Students’ Group

“…Surprisingly smoking did not have a significant impact on asthma control levels in our study. Nevertheless, tobacco is considered a risk factor in terms of the severity of asthma [21,22].…”

The role of spirometry in the management of obstructive airways disease: How pharmacists should get involved

“…Unfortunately, spirometry is significantly underutilized in primary care, with estimations of only about 50% to 60% of patients having had a single spirometry in the management of their asthma 1 or COPD. 2,3 Although the words are often used interchangeably, it is important to note that there is a difference between spirometry and pulmonary function testing (PFT).…”