Uncontrolled asthma and its risk factors in adult Chinese asthma patients

Abstract

Background:Asthma affects a large number of patients in China, but relatively little is known about asthma management among Chinese patients. This study aims to estimate asthma control rate among adult Chinese patients and to identify predictors associated with uncontrolled asthma.Methods:A total of 4125 asthma patients aged ⩾17 years and representing all regions of mainland China except Tibet were surveyed. Asthma control status was assessed using the Asthma Control Test (ACT) and classified as controlled (ACT score ⩾ 20) and uncontrolled (ACT score ⩽ 19). A multivariate logistic regression model was used to identify predictors associated with uncontrolled asthma from the factors including demographics, rhinitis, allergic rhinitis, and treatment adherence.Results:Asthma was controlled in 44.9%, and uncontrolled in 55.1% of the study participants. High rates of uncontrolled asthma were found in patients with treatment nonadherence (77.3%), poor adherence (66.2%), no schooling (64.8%), or obesity (62.9%). The risk of uncontrolled asthma was much higher in the treatment nonadherence group than the complete adherence group [odds ratio (OR) = 4.55 (3.68–5.62), p < 0.001]. Other predictors for uncontrolled asthma included concomitant rhinitis [OR = 1.31 (1.14–1.50), p < 0.001], obesity [OR = 1.31 (1.05–1.64), p = 0.019], asthma duration > 3 years [OR = 1.22 (1.07–1.39), p = 0.004] and age ⩾ 45 years [OR = 1.23 (1.07–1.41), p = 0.004].Conclusions:About half of the participants in this study had uncontrolled asthma. Treatment nonadherence is one of the significant predictors, which is very strongly associated with uncontrolled asthma. Efforts should be prioritized to promote patients’ treatment adherence to improve asthma control while attention is needed on rhinitis or obesity.

CARE: An Observational Study of Adherence to Home Nebulizer Therapy Among Children with Asthma

“…In the present study, the median treatment adherence rate reported by portable home nebulizer devices was 69.9%, which compares favourably to many previous reports among children in other regions worldwide: the median electronically monitored adherence was 58.4% and 46%, respectively, in two studies in the USA [6,12,13], changing from 54% and 41% at Month 4 to 47% and 31.5% at Month 12 in patients with controlled and uncontrolled asthma, respectively, in a study from Brazil [14], and 49.5% in a study from The Netherlands [15]. Results of the present study also compared favourably to other studies in China investigating treatment adherence in patients with asthma (adults or children) [16][17][18]. Furthermore, the World Health Organization reported that mean adherence was approximately 50% based on key studies in adults and children [19].…”

Determinants of Uncontrolled Asthma Among Adult Asthmatic Patients on Follow-Up at Chest Clinic of Jimma Medical Center: Unmatched Case-Control Study

“…In this study, asthmatic patients whose age was 35 or above were nearly three times more likely to have uncontrolled asthma when compared with those whose age was between 18 and 34. This nding is supported by studies done in Spain (32), China (33), and Saudi Arabia (15). Similarly, a study done in Jimma, Ethiopia, also stated that the probability of getting well-controlled asthma was more than three times higher in the age group of 14-34 years than older age groups (21).…”

To Determine the Frequency of Various Factors Leading to Uncontrolled Asthma in Asthmatic Population (>16 Years of Age)

“…Oshikoya et al demonstrated that alternative medicine used by 25% of asthmatics, 8 Dalcin et al reported that 48.5% were not using inhaler properly. 7 Non-compliance about medication is another factor present in about 50% in asthmatics by. 9 Recent international guidelines define asthma control in terms of two domains: impairment and risk.…”

“…It was observed that 48.5% were not using inhaler properly with 12.6% using oral medication (oral xanthenes steroids) instead of inhaler therapy which is corner stone of current asthma treatment. 7 Non-compliance about medication is another factor present in about 50% in asthmatics. 9 Psychological fears about medication side effects are also prevalent in about 14.2%, thus compromising regular medication use.…”

“…5 One study show 3.6% of asthmatics still smokes making asthma difficult to control. 7 The goal of asthma treatment is that patient should experience no or minimal symptoms. When uncontrolled, asthma can place very severe restrictions on daily activities and also causes significant psychological stress.…”