Zeru Tesfalidet Gebremeskel, Engidawork Ephrem, Berha Alemseged Beyene
Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Pulm Med. 2020 Jul 28;2020:5389780. doi: 10.1155/2020/5389780. eCollection 2020.
The primary goal of asthma management is to achieve good asthma control. However, poor patient-physician communication, unavailability of appropriate medications, and lack of long-term goals have made asthma control difficult in developing countries. Poor assessment of asthma control and quality of life is a major cause of suboptimal asthma treatment worldwide, and information regarding this issue is scanty in developing countries like Ethiopia. This study thus attempted to assess the level of asthma control and quality of life in asthmatic patients attending Armed Forces Referral and Teaching Hospital.
A cross-sectional study comprising 184 physician-diagnosed asthmatic patients was conducted using interview, chart review, and prescription assessment. Asthma control was assessed using Asthma Control Test, while asthma quality of life was assessed using Mini-Asthma Quality of Life Questionnaire (mini-AQLQ). Spearman's rank correlation analysis was performed to understand the relationship between mean mini-AQLQ score and asthma control. Receiver operating characteristic curve analysis was performed to establish cut-off values for mini-AQLQ.
Asthma was uncontrolled in 67.9% subjects. There was a strong correlation between asthma control and quality of life (rs = 0.772; < 0.01). A cut-off value for the quality of life was established at 4.97. Majority of the patients were taking two or three antiasthmatic drugs. Oral tablet and inhaler short-acting beta agonists (SABA) were the frequently combined drugs. Uncontrolled asthma was associated with middle-aged adults (adjusted odds ratio (AOR) = 6.31; 95% CI: 2.06, 19.3; = 0.001), male gender (AOR = 0.38; 95% CI: 0.15, 0.98; = 0.044), married (AOR = 0.24; 95% CI: 0.08, 0.78; = 0.017), comorbidities (AOR = 0.23; 95% CI: 0.09, 0.61; = 0.003), and oral SABA use (AOR = 0.22; 95% CI: 0.09, 0.59; = 0.003). Male gender (AOR = 0.36; 95% CI: 0.16, 0.84; = 0.018), intermittent asthma (AOR = 0.18; 95% CI: 0.04, 0.86; = 0.032), use of oral corticosteroids (AOR = 0.22; 95% CI: 0.06, 0.73; = 0.013), and SABA (AOR = 0.39; 95% CI: 0.17, 0.89; = 0.026) were found to have a significant association with poor asthma-related quality of life.
The findings collectively indicate asthma remains poorly controlled in a large proportion of asthma patients in the study setting. Moreover, quality of life appears to be directly related to asthma control. Healthcare providers should therefore focus on asthma education with an integrated treatment plan to improve asthma control and quality of life.
哮喘管理的主要目标是实现良好的哮喘控制。然而，患者与医生之间沟通不畅、缺乏合适的药物以及缺乏长期目标，使得发展中国家的哮喘控制变得困难。对哮喘控制和生活质量的评估不佳是全球哮喘治疗未达最佳效果的主要原因，而在像埃塞俄比亚这样的发展中国家，关于这个问题的信息很少。因此，本研究试图评估在武装部队转诊和教学医院就诊的哮喘患者的哮喘控制水平和生活质量。
采用访谈、病历审查和处方评估对184名经医生诊断的哮喘患者进行了横断面研究。使用哮喘控制测试评估哮喘控制情况，同时使用迷你哮喘生活质量问卷（mini - AQLQ）评估哮喘生活质量。进行Spearman等级相关分析以了解平均mini - AQLQ评分与哮喘控制之间的关系。进行受试者工作特征曲线分析以确定mini - AQLQ的临界值。
67.9%的受试者哮喘未得到控制。哮喘控制与生活质量之间存在很强的相关性（rs = 0.772；P < 0.01）。生活质量的临界值确定为4.97。大多数患者正在服用两种或三种抗哮喘药物。口服片剂和吸入短效β受体激动剂（SABA）是常用的联合用药。未控制的哮喘与中年成年人（调整后的优势比（AOR）= 6.31；95%置信区间：2.06，19.3；P = 0.001）、男性（AOR = 0.38；95%置信区间：0.15，0.98；P = 0.044）、已婚（AOR = 0.24；95%置信区间：0.08，0.78；P = 0.017）、合并症（AOR = 0.23；95%置信区间：0.09，0.61；P = 0.003）以及口服SABA的使用（AOR = 0.22；95%置信区间：0.09，0.59；P = 0.003）有关。男性（AOR = 0.36；95%置信区间：0.16，0.84；P = 0.018）、间歇性哮喘（AOR =
