Impact of Asthma Control Status on Lung Function and Patient Well-Being Assessments in Patients with Severe, Uncontrolled Asthma

Asthma is the most common chronic medical condition affecting pregnancy. Optimizing asthma management in pregnancy is paramount for the well-being of both the mother and the baby. The primary objectives of this study were to assess patient’s knowledge about asthma, the level of asthma care, and fetal and maternal outcomes among pregnant asthmatic women in this wealthy country with tremendous improvement in maternal and fetal health care. The secondary objective was to identify barriers to asthma control. This was a cross-sectional, face-to-face, prospective study of 80 pregnant women with physician-diagnosed asthma. About 56% of patients reported worsening of their asthma control during pregnancy, of which 52.3% felt this worsening in the third trimester. About 65% of patients had uncontrolled asthma during their pregnancy, and inhaler technique was incorrect in 64.4%. Only 38% of patients knew the difference between controller and reliever asthma medications, 12.7% of patients had received written asthma action plan, 17% had a spirometry done in the previous 5 years, and 3.8% had peak expiratory flow meter at home. The main reasons for uncontrolled asthma were lack of knowledge about right asthma medications in 30% and fear of side effects of inhaled corticosteroids in 19% of patients. No financial reason was reported. Significant associations between total number of pregnancies, poor perception of asthma medications, asthma exacerbation during delivery and poor asthma control were observed. Preeclampsia and congenital anomalies occurred at higher rates than previously reported among general population in this country. The tremendous improvements in maternal health care and socioeconomic status do not seem to be a barrier to the globally recognized poor asthma care in pregnancy. Important strategies are much needed.

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Assessment of disease control in patients with asthma

Medicina ◽

10.3390/medicina45120121 ◽

2009 ◽

Vol 45 (12) ◽

pp. 943 ◽

Cited By ~ 1

Author(s):

Guoda Pilkauskaitė ◽

Kęstutis Malakauskas ◽

Raimundas Sakalauskas

Keyword(s):

Lung Function ◽

Asthma Control ◽

Control Level ◽

Asthma Management ◽

Control Test ◽

Uncontrolled Asthma ◽

Asthma Control Test ◽

Inhaled Steroids ◽

Asthma Patients ◽

Β2 Agonists

International guidelines indicate that the main criterion of asthma management is asthma control level. The aim of this study was to assess asthma control and its relation with age, gender, and lung function. Material and methods. A total of 106 family physicians and 13 pulmonologists and allergists took part in this study. Each doctor had selected 10–15 asthma patients and had sent invitations to them by post. On the visit day, the patients themselves filled in the Asthma Control Test. The doctors interviewed the patients and filled in a special questionnaire. Pulmonologists and allergists also assessed lung function by performing spirometry. According to the results of the Asthma Control Test, the disease control level was indicated as “totally controlled” (25 points), “well controlled” (24–20 points), and “uncontrolled” (19 points or less). Results. A total of 876 asthma patients were examined. Uncontrolled asthma was diagnosed to 56.2% of the patients, 36.5% of patients had well controlled and 7.3% totally controlled asthma. There was no significant difference in asthma control level comparing men and women. A correlation between asthma control level and age was found revealing poorer asthma control in older patients. Ninety-five percent of patients were treated with inhaled steroids; most of them had used inhaled steroids in combination with long-acting β2 agonists. It was found that lung function correlated with clinical symptoms of asthma, the demand of shortacting β2 agonists, and asthma control level. Conclusion. The study showed that uncontrolled asthma was diagnosed to more than half of the patients, despite most of them used inhaled steroids. Asthma control was worsening with the age of patients with asthma and it correlated with lung function. We suggest that periodical assessment of asthma control should help to optimize asthma management.

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Predictors of asthma control and lung function responsiveness to step 3 therapy in children with uncontrolled asthma

Journal of Allergy and Clinical Immunology ◽

10.1016/j.jaci.2013.07.039 ◽

2014 ◽

Vol 133 (2) ◽

pp. 350-356 ◽

Cited By ~ 29

Author(s):

Nathan Rabinovitch ◽

David T. Mauger ◽

Nichole Reisdorph ◽

Ronina Covar ◽

Jonathan Malka ◽

...

Keyword(s):

Lung Function ◽

Asthma Control ◽

Uncontrolled Asthma

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Follow-up of patients with uncontrolled asthma: clinical features of asthma patients according to the level of control achieved (the COAS study)

European Respiratory Journal ◽

10.1183/13993003.01885-2015 ◽

2017 ◽

Vol 49 (3) ◽

pp. 1501885 ◽

Cited By ~ 5

Author(s):

Rosa Munoz-Cano ◽

Alfons Torrego ◽

Joan Bartra ◽

Jaime Sanchez-Lopez ◽

Rosa Palomino ◽

...

Keyword(s):

Lung Function ◽

Asthma Control ◽

Forced Expiratory Volume ◽

Uncontrolled Asthma ◽

Asthma Control Test ◽

Disease Evolution ◽

Factors Associated ◽

Asthma Patients ◽

The Mean ◽

Global Initiative

Our aim was to study the asthma control achieved in patients with uncontrolled asthma who had received appropriate treatment according to the Global Initiative for Asthma (GINA) 2010 (valid at the time the study was designed), and to analyse the factors associated with a lack of asthma control.This was a multicentre study in routine clinical practice performed in patients with uncontrolled asthma according to GINA 2010. At visit 1, we recorded demographics, asthma characteristics and spirometry. We assessed asthma control using GINA 2010 criteria and the Asthma Control Test (ACT). Treatment was optimised according to GINA 2010. At visit 2, 3 months later, we reassessed spirometry, asthma control and factors associated with failure to achieve control.We recruited 1299 patients with uncontrolled asthma (mean age 46.5±17.3 years, 60.7% women, 25.8% obese). The mean percentage of predicted forced expiratory volume in 1 s was 76.4±12.8% and the mean post-bronchodilator increase was 14.9±6.8%. We observed poor agreement between ACT and GINA 2010 when evaluating asthma control (kappa = −0.151). At visit 2, asthma in 71.2% of patients was still not fully controlled. Patients whose asthma remained uncontrolled were older, had a higher body mass index, greater disease severity, longer disease evolution and worse lung function.After treatment optimisation, most patients did not achieve optimal control according to GINA 2010. Risk factors for failure to achieve asthma control were time of disease evolution, severity, age, weight and lung function impairment (excluded in the GINA 2014).

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Non-Inferior Improvement in Asthma Quality of Life and Favorable Benefit in Terms of Lung Function and Asthma Control with Inhaled Combination of Indacaterol/Glycopyrronium/Mometasone Furoate Once-Daily Compared with the "Loose" Combination of Salmeterol/Fluticasone Twice-Daily Plus Tiotropium in Patients with Uncontrolled Asthma: Results of the Phase III ARGON Study

10.1164/ajrccm-conference.2020.201.1_meetingabstracts.a3010 ◽

2020 ◽

Author(s):

C. Gessner ◽

O. Kornmann ◽

J. Maspero ◽

R. van Zyl-Smit ◽

M. Krüll ◽

...

Keyword(s):

Quality Of Life ◽

Lung Function ◽

Asthma Control ◽

Mometasone Furoate ◽

Phase Iii ◽

Uncontrolled Asthma ◽

Once Daily

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The Relation between Asthma Control and Quality of Life in Children

International Journal of Pediatrics ◽

10.1155/2018/6517329 ◽

2018 ◽

Vol 2018 ◽

pp. 1-6 ◽

Cited By ~ 4

Author(s):

M. Banjari ◽

Y. Kano ◽

S. Almadani ◽

A. Basakran ◽

M. Al-Hindi ◽

...

Keyword(s):

Quality Of Life ◽

Asthma Control ◽

Holistic Approach ◽

Well Being ◽

Life Questionnaire ◽

Uncontrolled Asthma ◽

Asthma Control Test ◽

Cross Sectional ◽

Asthmatic Children

Background. Asthma is a common chronic illness worldwide. Asthmatic children are forced to alter their way of living to avoid its complications or exacerbations, which negatively affects their psychological and social well-being. High prevalence of behavioral and emotional difficulties was noticed among children with asthma. Methods. Cross-sectional study that was conducted over 8 months involving asthmatic children within the ages of 7-17 years presenting to two governmental hospitals in Jeddah, Saudi Arabia. Three questionnaires were used: asthma control test, the strengths and difficulties questionnaire, and the pediatrics asthma quality of life questionnaire. Using SPSS, Pearson’s chi-square and independent sample t-tests were used to find associations. Results. Among the 106 respondents, 84% of the sample had poor asthma control. Significantly poorer quality of life was observed in children with uncontrolled asthma (p = <0.001). Children with controlled and uncontrolled asthma were equally affected psychosocially with no relation between asthma control and their psychosocial well-being (p = 0.58). Conclusion. The majority of asthmatic children were uncontrolled with poor quality of life. This study recommends that the psychosocial well-being should be assessed during clinic visits for a better holistic approach and effective improvement of outcome. Further researches are needed to study the psychological effect of asthma.

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