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Uncontrolled asthma occurs in all GINA treatment steps and is associated with worse physical health: a report from the OLIN adult asthma cohort
Luleå University of Technology, Department of Health Sciences, Nursing Care. Section of Medicine, The OLIN Unit, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.ORCID iD: 0000-0001-6622-3838
Department of Care Sciences, Faculty of Health and Society, Malmö University, Malmö, Sweden.
Section of Medicine, The OLIN Unit, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
Section of Sustainable Health, The OLIN Unit, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
2020 (English)In: Journal of Asthma, ISSN 0277-0903, E-ISSN 1532-4303Article in journal (Refereed) Epub ahead of print
Abstract [en]

Objective: To study asthma exacerbations, healthcare utilization and health status among subjects with asthma with different treatment regimens and levels of asthma control.

Methods: In 2012–2014, n = 1425 adults from a population-based asthma cohort within the OLIN studies (Obstructive Lung disease in Northern Sweden) were invited to a follow-up including spirometry and a structured interview, n = 1006 participated. Asthma Control Test (ACT) was used to detect uncontrolled asthma, and physical and mental dimensions of health were measured with SF-8. Pharmacological treatment use was classified by Global Initiative for Asthma treatment steps. Out of n = 830 with current asthma, n = 714 answered ACT (57% women, 32–92 years) and were included in the study.

Results: Uncontrolled asthma increased per treatment step (no treatment 9.9%, treatment step 1–3 24.1%, and treatment steps 4–5 39.9%, p < 0.001). A higher proportion of subjects with uncontrolled asthma reported exacerbations, healthcare utilization, and worse health status than those with controlled asthma. The proportion of subjects reporting exacerbations, healthcare visits, emergency room visits and regular follow-up visits increased per treatment step. Worse health was associated with uncontrolled asthma, but not with the level of treatment. A higher proportion of women than men reported exacerbations, any healthcare visits, and lower health. Regular follow-up visits to a physician were uncommon (women 21.2% vs. men 14.6%, p = 0.022).

Conclusions: Uncontrolled asthma is common in all treatment steps, and is associated with worse health status. However, health status did not differ by treatment steps. Identifying subjects with uncontrolled asthma regardless of treatment regimens should be a priority, thus follow-up visits are important.

Place, publisher, year, edition, pages
Taylor & Francis, 2020.
Keywords [en]
Epidemiology, management/control, quality of life, treatment
National Category
Nursing
Research subject
Nursing
Identifiers
URN: urn:nbn:se:ltu:diva-77776DOI: 10.1080/02770903.2020.1713150ISI: 000506948200001PubMedID: 31910044OAI: oai:DiVA.org:ltu-77776DiVA, id: diva2:1394666
Available from: 2020-02-19 Created: 2020-02-19 Last updated: 2020-04-14

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