Asthma diagnosis and treatmentDeterminants of future long-term asthma control
Section snippets
Patients
Surveys were sent in August 2000 to a random sample of Kaiser-Permanente Medical Care Program adult members aged 18 to 56 years from the Northern California (n = 3072), Northwest (n = 543), and Southern California (n = 3251) regions who were given diagnoses of persistent asthma based on the presence of one or more of the following National Committee for Quality Assurance Health Plan Data and Information Set (HEDIS)15 administrative database criteria (during 1999): (1) 4 or more asthma
Results
The number of patients at each β-agonist long-term control scale level in 2001 was as follows: level 1 (0-2 canisters per year), 668 (29.7%); level 2 (3-6 canisters per year), 539 (24.0%); level 3 (7-12 canisters per year), 520 (23.1%); and level 4 (>12 canisters per year), 523 (23.2%). Long-term asthma control was significantly and inversely related to all severity-related asthma utilization measures tested (Table I). Table I shows both bivariate associations and, in the final column, the
Discussion
Asthma control is the goal of asthma therapy, and thus its relationship to asthma severity and other factors is of great clinical importance. Asthma severity can be defined as the inherent biologic intensity of the disease process11 and can be inferred from the intensity of the management necessary to achieve control.17 Severe exacerbations are also markers of asthma severity.18 Vollmer13 has developed a hypothetic construct of asthma control that suggests it is inversely related to inherent
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2021, Journal of Allergy and Clinical Immunology: In PracticeCitation Excerpt :Although several studies have attempted to identify predictors for poor asthma control5-14 or asthma exacerbations,15-17 these outcomes were studied in separate populations in the vast majority of studies. For example, older age,5,6 lower socioeconomic status,5 low level of education,6,7 multiple comorbidities,5 insurance status,8 smoking,6,8 obesity,6-11 prior hospital admission for asthma,12 low lung function,14 low adherence to treatment,5 and poor baseline asthma control7,13 were associated with poor asthma control in studies that did not assess asthma exacerbations. In contrast, occurrence of previous asthma exacerbations,16,18 low forced expiratory volume in 1 second (FEV1),16 insurance status,18 and high blood eosinophil count17 were associated with asthma exacerbations in studies that did not report asthma control.
Inhaled corticosteroids and asthma control in adult-onset asthma: 12-year follow-up study
2018, Respiratory MedicineCitation Excerpt :Even though some interventional studies have shown that good asthma control can be achieved by stepping up treatment or by follow-up interventions [19,20], surprisingly large proportion of patients remain uncontrolled after stepping up the therapy [12]. Factors such as smoking and concurrent chronic obstructive disease, obesity, male sex and rhinitis have been reported to associate with an increased risk of uncontrolled asthma [8,21]. This suggests that a poor disease control may result from several events occurring longitudinally.
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Supported by the Kaiser-Permanente Care Management Institute, Oakland, Calif.
Disclosure of potential conflict of interest: The authors have declared that they have no conflict of interest.