Factors Contributing Towards Poor Asthma Control in Patients on Regular Medication
Introduction: In-spite of the availability of effective medications, it is observed that patients with bronchial asthma on treatment are poorly controlled. An objective evaluation of asthma control especially with respect to inflammation and the factors contributing towards poor control is cruci...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2016-06-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/8052/18670_CE(RA1)_F(T)_PF1(VSUAK)_PFA(AK)_PF2(PAG).pdf |
| Summary: | Introduction: In-spite of the availability of effective medications,
it is observed that patients with bronchial asthma on treatment
are poorly controlled. An objective evaluation of asthma
control especially with respect to inflammation and the factors
contributing towards poor control is crucial in obtaining relief of
symptoms.
Aim: 1) To measure the asthma control using modified Mini
Asthma Quality Of Life Questionnaire (MAQOL) and sputum
eosinophil count; 2) To identify the role of factors viz. age,
duration of asthma, severity, compliance, technique of inhalation
and knowledge of asthma action plan on asthma control.
Materials and Methods: Total 50 asthmatic patients on
regular medication were included in the study after obtaining
written informed consent. The asthma-control was evaluated
based on history, clinical symptoms, need for short-acting
bronchodilators, FEVs1
and sputum eosinophil count with
the help of modified MAQOL. A global score of <80% was
considered as poor control. The proportion of patients under
each factor, in poorly-controlled group (PC) was compared with
the well-controlled group (WC). The results were analysed using
descriptive statistics and unpaired student’s t-test.
Results: Of the total, 33 (66%) patients were in PC category
with a mean global asthma score of 58.46 ± 2.881 vs 85.2 ±
1.19 in the WC group (34%) (p<0.05). The mean age in PC was
41.41 ± 2.413 vs 29.00 ± 2.157(p<0.05) in the WC. The mean
duration of asthma was 16.76 ± 2.761 in PC vs 7.882 ± 2.065
years in WC (p<0.05). The severity score was 7.265 ± 0.4434 in
PC vs 6.706 ± 0.64 in WC. Eight patients in PC and six in WC
were unaware of the treatment plan. One in PC group and three
in WC were unaware of technique of inhalation. One in PC group
and three in WC were non–compliant. Mean sputum eosinophil
count was 7.441 ± 1.081 in PC vs 5.176 ± 1.201 in WC.
Conclusion: MAQOL is useful in evaluating asthma-control.
Sputum eosinophil count correlates with asthma-control.
Duration of asthma, age and severity contributed significantly
to the poor control of asthma. There is a need for an objective
monitoring in asthma and the treatment strategies need to be
modified accordingly. |
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| ISSN: | 2249-782X 0973-709X |