Factors influencing asthma control: results of a real-life prospective observational asthma inhaler treatment (ASIT) study

Abstract

Background

Despite the availability of new pharmacological options and novel combinations of existing drug therapies, the rate of suboptimal asthma control is still high. Therefore, early identification of the clinical and behavioral factors responsible for poor asthma control, and interventions during routine outpatient visits to improve asthma trigger management, are strongly recommended. This study was designed to evaluate the profiles of asthmatic patients and their inhaler treatment devices in relation to asthma control in Turkey.

Methods

A total of 572 patients with persistent asthma (mean [standard deviation] age: 42.7 [12.1] years; 76% female) were included in this prospective observational study. A baseline visit (0 month, visit 1) and three follow-up visits (1, 3 and 6 months after enrolment) were conducted to collect data on demographics, past medical and asthma history, and inhaler device use.

Results

Asthma control was identified in 61.5% of patients at visit 1 and increased to 87.3% at visit 4 (P < 0.001), regardless of sociodemographics, asthma duration, body mass index or smoking status. The presence of asthma-related comorbidity had a significantly negative effect on asthma control (P = 0.004). A significant decrease was determined, in the rate of uncontrolled asthma, upon follow-up among patients who were using a variety of fixed dose combination inhalers (P < 0.001 for each). Logistic regression analysis was used to show that the presence of asthma-related comorbidity (odds ratio [OR], 0.602; 95% confidence interval [CI], 0.419; 0.863, P = 0.006) and active smoking (OR, 0.522; 95% CI, 0.330; 0.825, P = 0.005) were significant predictors of asthma control.

Conclusion

Our findings indicate that, despite ongoing treatment, asthma control rate was 61.5% at visit 1 in adult outpatients with persistent asthma. However, by the final follow-up 6 months later, this had increased to 87.3%, independent of sociodemographic and clinical characteristics. Poor asthma control was associated with asthma-related comorbid diseases, while the efficacy of fixed dose combinations was evident in the achievement of asthma control.

Keywords:

• persistent asthma
• patient profile
• asthma control
• inhaler treatment
• adults
• Turkey

Acknowledgments

This study is funded by Chiesi İlac Tic. A.S. Turkiye. We would like to thank KAPPA Consultancy Training Research Ltd, Istanbul, for providing editorial support; Monitor CRO, Istanbul, for providing support in statistical analysis; and Aysegul Kahraman from Chiesi Tic. A.S. Turkiye for her great efforts and contributions at all stages of the study publication. The author wrote this paper on behalf of the ASIT Study Group. The other members, (by the physician’s name in descending order of number of patients enrolled) are:

1. Yıldız F, Study Coordinator (Department of Pulmonary Diseases, Kocaeli University School of Medicine, Kocaeli)

2. Erbagci A (Zonguldak Uzun Mehmet Chest Diseases Hospital, Zonguldak)

3. Demirel YS (Department of Chest Diseases, Ankara University, School of Medicine, Ankara)

4. Akcalı SD (Chest Diseases Clinic, Ankara Dıskapı Yıldırım Beyazıt Hospital, Ankara)

5. Ekici A (Department of Chest Diseases, Kirikkale University, School of Medicine, Kirikkale)

6. Dursunoglu N (Department of Chest Diseases,Pamukkale University School of Medicine,Denizli)

7. Ediger D (Department of Chest Diseases, Uludag University, School of Medicine, Bursa)

8. Erdinc M (Department of Chest Diseases, Ege University, School of Medicine, Izmir)

9. Cemri SC (Chest Diseases Clinic, Mersin State Hospital, Mersin)

10. Kalyoncu AF (Department of Chest Diseases, Hacettepe University, School of Medicine, Ankara)

11. Guclu SZ (Dr. Suat Seren Chest Diseases Hospital, Izmir)

12. Aktogu S (Dr. Suat Seren Chest Diseases Hospital, Izmir)

13. Bayramgurler B (Chest Diseases Clinic, Derince Research and Training Hospital, Kocaeli)

14. Bayram M (Chest Diseases Clinic, Sivas Numune Research and Training Hospital, Sivas)

15. Akgun M (Department of Chest Diseases, Erzurum Atatürk University, School of Medicine, Erzurum)

16. Mirici A (Department of Chest Diseases, Canakkale 18 March University, School of Medicine, Canakkale)

17. Akyildiz L (Chest Diseases Clinic, Private Park Hospital, Mardin)

18. Celik P (Department of Chest Diseases, Celal Bayar University, School of Medicine, Manisa)

19. Guven AO (Nihat Kitapci Chest Diseases Hospital, Erzurum)

20. Camsari G (Yedikule Chest Diseases Hospital, Istanbul)

21. Ozseker F (Sureyyapasa Chest Diseases Hospital, Istanbul)

22. Cimen F (Atatürk Chest Diseases Hospital, Ankara)

23. Kurutepe M (Sureyyapasa Chest Diseases Hospital, Istanbul)

24. Senyigit A (Department of Chest Diseases, Dicle University, School of Medicine, Diyarbakir)

25. Bektas Y (Trabzon Chest Diseases Hospital, Trabzon)

26. Ozbudak O (Department of Chest Diseases, Akdeniz University, School of Medicine, Antalya)

27. Saylan B, Baslilar S (Chest Diseases Clinic, Umraniye Research and Training Hospital, Istanbul)

28. Polatli M (Department of Chest Diseases, Adnan Menderes University, School of Medicine, Aydin)

29. Cagatay T (Department of Chest Diseases, Istanbul University, Istanbul School of Medicine, Istanbul)

30. Kalkan S (Chest Diseases Clinic, Private Batman Hospital, Batman)

31. Ozer A (Chest Disease Clinic, Cukurova State Hospital, Adana).

Disclosure

The author declares no conflict of interests in this paper.