Belachew Eyayaw Ashete, Tadess Sumeya, Alemayehu Mekuriaw, Ayele Emneteab Mesfin
Department of Clinical Pharmacy, University of Gondar, P. O. Box - 196, Gondar, Ethiopia.
Institute of Public Health, University of Gondar, P. O. Box - 196, Gondar, Ethiopia.
Asthma Res Pract. 2022 Aug 27;8(1):5. doi: 10.1186/s40733-022-00087-3.
Asthma is a major public health challenge and is characterized by recurrent attacks of breathlessness and wheezing that vary in severity and frequency from person to person. Asthma control is an important measure of health outcomes of the patients with asthma and reflecting the impact of an illness and its treatment from the patient's perspective. Therefore, this study assessed the asthma control levels and their determinants among adults living with asthma in selected public referral hospitals in northwestern Ethiopia.
A multicenter institutional-based cross-sectional study was conducted in North-western Ethiopia, from October to December 2021. A systematic random sampling technique was employed to recruit the study participants. Bi-variable and multivariable ordinal logistic regression was used to determine the independent predictors of asthma control levels. A p-value of < 0.05 was considered as statistically significant.
A total of 409 patients were included in the final analysis. Asthma was controlled by 28.9% with 95%CI (24.7, 33.5) people who have asthma. Regarding the potential predictor of asthma control level, being male (AOR = 6.5, 95%CI (1.28, 32.44), Married (AOR = 3.62, 95%CI (1.28, 10.27), healthcare provider adherence to guideline usage (AOR = 8.4,95%CI (2.7, 26) and non-fuel users (AOR = 6.0, 95%CI (1.5, 22.5) were variables that increase asthma control. However, non-adherent to medication (AOR = 0.16, 95%CI (0.059, 0.48), low level of patient enablement (AOR = 0.19, (95%CI) (0.08, 0.49) and poor relationship with healthcare provider (AOR = 0.024,95%CI (0.02, 0.23) were variables that significantly decreased asthma control level.
The findings indicated that asthma control remains suboptimal in a large proportion of patients with asthma in the study setting. Socio-demographic, clinical, healthcare-related, and medication-related variables were significantly associated with asthma control. Therefore, our study highlights multifaceted interventions, including comprehensive asthma education along with an integrated treatment plan to improve asthma control and quality of life.
哮喘是一项重大的公共卫生挑战，其特征为反复发作的呼吸急促和喘息，严重程度和发作频率因人而异。哮喘控制是哮喘患者健康结局的一项重要指标，反映了疾病及其治疗对患者的影响。因此，本研究评估了埃塞俄比亚西北部选定的公立转诊医院中成年哮喘患者的哮喘控制水平及其决定因素。
2021年10月至12月在埃塞俄比亚西北部开展了一项基于多中心机构的横断面研究。采用系统随机抽样技术招募研究参与者。使用双变量和多变量有序逻辑回归来确定哮喘控制水平的独立预测因素。p值<0.05被认为具有统计学意义。
共有409名患者纳入最终分析。28.9%（95%CI（24.7，33.5））的哮喘患者哮喘得到控制。关于哮喘控制水平的潜在预测因素，男性（调整后比值比[AOR]=6.5，95%CI（1.28，32.44））、已婚（AOR=3.62，95%CI（1.28，10.27））、医疗服务提供者遵循指南使用情况（AOR=8.4，95%CI（2.7，26））和非燃料使用者（AOR=6.0，95%CI（1.5，22.5））是提高哮喘控制的变量。然而，不坚持用药（AOR=0.16，95%CI（0.059，0.48））、患者能力水平低（AOR=0.19，95%CI（0.08，0.49））以及与医疗服务提供者关系不佳（AOR=0.024，95%CI（0.02，0.23））是显著降低哮喘控制水平的变量。
研究结果表明，在研究环境中，很大一部分哮喘患者的哮喘控制仍未达到最佳水平。社会人口统计学、临床、医疗保健相关和药物相关变量与哮喘控制显著相关。因此，我们的研究强调了多方面的干预措施，包括全面的哮喘教育以及综合治疗计划，以改善哮喘控制和生活质量。
