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...

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Main Authors: Siddharth Gosavi, Pratibha Nadig, Alamelu Haran
Format: Article
Language:English
Published: JCDR Research and Publications Private Limited 2016-06-01
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
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author Siddharth Gosavi
Pratibha Nadig
Alamelu Haran
author_facet Siddharth Gosavi
Pratibha Nadig
Alamelu Haran
author_sort Siddharth Gosavi
collection DOAJ
description 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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spelling doaj.art-b973ec80afe8444b898b2b0c6fd22aef2022-12-22T00:07:17ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2016-06-01106OC31OC3510.7860/JCDR/2016/18670.8052Factors Contributing Towards Poor Asthma Control in Patients on Regular MedicationSiddharth Gosavi0Pratibha Nadig1Alamelu Haran2Intern Medical Officer, Vydehi Institute of Medical Sciences & Research Centre, Bengaluru, Karnataka, India.Professor and Head of Department, Department of Pharmacology, Vydehi Institute of Medical Sciences & Research Centre, Bengaluru, Karnataka, India.Professor and Head of Department, Department of Pulmonary Medicine, Vydehi Institute of Medical Sciences & Research Centre, Bengaluru, Karnataka, India.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.https://jcdr.net/articles/PDF/8052/18670_CE(RA1)_F(T)_PF1(VSUAK)_PFA(AK)_PF2(PAG).pdfmini asthma quality of life questionnairerisk factorssputum eosinophil analysis
spellingShingle Siddharth Gosavi
Pratibha Nadig
Alamelu Haran
Factors Contributing Towards Poor Asthma Control in Patients on Regular Medication
Journal of Clinical and Diagnostic Research
mini asthma quality of life questionnaire
risk factors
sputum eosinophil analysis
title Factors Contributing Towards Poor Asthma Control in Patients on Regular Medication
title_full Factors Contributing Towards Poor Asthma Control in Patients on Regular Medication
title_fullStr Factors Contributing Towards Poor Asthma Control in Patients on Regular Medication
title_full_unstemmed Factors Contributing Towards Poor Asthma Control in Patients on Regular Medication
title_short Factors Contributing Towards Poor Asthma Control in Patients on Regular Medication
title_sort factors contributing towards poor asthma control in patients on regular medication
topic mini asthma quality of life questionnaire
risk factors
sputum eosinophil analysis
url https://jcdr.net/articles/PDF/8052/18670_CE(RA1)_F(T)_PF1(VSUAK)_PFA(AK)_PF2(PAG).pdf
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