Eriksson Sofia, Giezeman Maaike, Hasselgren Mikael, Janson Christer, Kisiel Marta A, Montgomery Scott, Nager Anna, Sandelowsky Hanna, Ställberg Björn, Sundh Josefin, Lisspers Karin
Region Dalarna, Falun, Sweden.
School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
J Asthma Allergy. 2024 Jul 9;17:621-632. doi: 10.2147/JAA.S460051. eCollection 2024.
To study risk factors for uncontrolled asthma and insufficient quality of life (QoL) in patients with mild asthma, ie those without preventer treatment.
Patients aged 18-75 years with a doctor's diagnosis of asthma randomly selected from primary and secondary care in Sweden. Mild asthma was defined as self-reported current asthma and no preventer treatment. Data were collected from self-completed questionnaires in 2012 and 2015. Well-controlled asthma was defined as Asthma Control Test (ACT) ≥20 points and no exacerbation and uncontrolled asthma as ACT<20 points and/or at least one exacerbation in the previous six months. QoL was measured by the Mini Asthma Quality of Life Questionnaire (Mini-AQLQ), where a total mean score of ≥ 6 indicated sufficient and < 6 insufficient QoL. Multivariate logistic regression analyses were performed using asthma control and Mini-AQLQ as dependent variables. Asthma control was dichotomized as controlled and uncontrolled asthma and the Mini-AQLQ as sufficient QoL (mean score ≥6) and insufficient QoL (mean score <6).
Among 298 patients, 26% had uncontrolled asthma, 40% insufficient QoL and 20% both uncontrolled asthma and insufficient QoL. Age ≥60 years, obesity, daily smoking, rhinitis and inadequate knowledge of asthma self-management were independently associated with poor asthma control. Factors independently associated with insufficient QoL were age ≥60 years, overweight, obesity, rhinitis, sinusitis and inadequate knowledge of asthma self-management. Age ≥60 years, obesity, rhinitis and inadequate knowledge of asthma self-management were independently associated with both uncontrolled asthma and insufficient QoL.
Among asthma patients without preventer medication, 26% had uncontrolled asthma and 40% had insufficient asthma-related QoL. Older age, obesity, and rhinitis were risk factors for both poor asthma control and a reduced QoL, but having good knowledge of asthma self-management reduced this risk. Our findings suggest that this group of patients requires further attention and follow-up.
研究轻度哮喘患者（即未接受预防治疗的患者）哮喘控制不佳及生活质量（QoL）低下的危险因素。
从瑞典初级和二级医疗机构中随机选取年龄在18 - 75岁、经医生诊断为哮喘的患者。轻度哮喘定义为自我报告的当前哮喘且未接受预防治疗。数据于2012年和2015年通过患者自行填写的问卷收集。哮喘控制良好定义为哮喘控制测试（ACT）≥20分且无急性加重，哮喘控制不佳定义为ACT<20分和/或在过去六个月内至少有一次急性加重。生活质量通过小型哮喘生活质量问卷（Mini - AQLQ）进行测量，其中总平均分≥6表示生活质量充足，<6表示生活质量不足。以哮喘控制情况和Mini - AQLQ为因变量进行多因素逻辑回归分析。哮喘控制情况分为控制良好的哮喘和控制不佳的哮喘，Mini - AQLQ分为生活质量充足（平均分≥6）和生活质量不足（平均分<6）。
在298名患者中，26%的患者哮喘控制不佳，40%的患者生活质量不足，20%的患者既哮喘控制不佳又生活质量不足。年龄≥60岁、肥胖、每日吸烟、鼻炎以及哮喘自我管理知识不足与哮喘控制不佳独立相关。与生活质量不足独立相关的因素有年龄≥60岁、超重、肥胖、鼻炎、鼻窦炎以及哮喘自我管理知识不足。年龄≥60岁、肥胖、鼻炎以及哮喘自我管理知识不足与哮喘控制不佳和生活质量不足均独立相关。
在未使用预防药物的哮喘患者中，26%的患者哮喘控制不佳，40%的患者哮喘相关生活质量不足。年龄较大、肥胖和鼻炎是哮喘控制不佳和生活质量降低的危险因素，但具备良好的哮喘自我管理知识可降低这种风险。我们的研究结果表明这组患者需要进一步关注和随访。
