Risk factors for poor asthma control and impaired quality of life in a Caribbean population

Abstract

Objective

Asthma, a major cause of disability and reduced quality of life, has a high global prevalence and burden of death. Despite the propitious guidelines, a substantial portion of asthmatics reportedly have poorly controlled disease. In the current study, we have examined risk factors for uncontrolled asthma in specialty clinics and its association with impaired quality of life.

Methods

A multicentre cross-sectional survey of asthma patients, 18 years and older, was conducted in Trinidad. Asthma Control Test (ACT) and the Juniper Mini Asthma Quality of Life Questionnaire (Mini AQLQ–J) were used to assess the disease control and quality of life, respectively. Data were analyzed using the Chi-square test and multivariable logistic regression controlling for gender.

Results

Of a total of 428 patients included, asthma was uncontrolled in 72.4% and asthma related quality of life was moderate to severely impaired in 86% of the studied population. In the multivariate regression models, poorly controlled asthma was associated with obesity (OR 2.25; 95% CI 1.30–3.39), late-onset asthma (OR 1.72; 95% CI 1.04–2.84), features of sleep apnea (OR 1.77; 95% CI 1.01–3.07) and depression (OR 2.01; 95% CI 1.04–3.86). Impaired quality of life was associated with Indo-Caribbean ethnicity (OR 3.19; 95% CI = 1.68–6.06).

Conclusions

In this Caribbean population, uncontrolled asthma was independently associated with obesity, late-onset disease, and comorbidities of sleep apnea and depression. Poor asthma-related quality of life was independently associated with Indo-Caribbean ethnicity.

Keywords:

• Asthma control
• asthma-related quality of life
• ethnicity
• obesity

Acknowledgements

We thank Jennifer Croft, Keston Rattan, Sabrina Rasmine, Dasha Harripersad, Mark Ramsoomair and Thias Razark for helping in data collection. We also thank Dr. Dottin Ramoutar, Dr. Michelle Trotman, Dr. Wilson Chin Soo, and Dr. Candice Gomez for facilitating the study.

Declaration of interest

The authors declare no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Funding

This work was not funded by any organization.