Assessment of disease control in patients with asthma

Guoda Pilkauskaitė¹, Kęstutis Malakauskas^{1, 2}, Raimundas Sakalauskas¹

¹Department of Pulmonology and Immunology, ²Institute for Biomedical Research, Kaunas University of Medicine, Lithuania

Key words: asthma; asthma control; Asthma Control Test.

Summary. International guidelines indicate that the main criterion of asthma management is asthma control level. The aim of this study was to assess asthma control and its relation with age, gender, and lung function.

Material and methods. A total of 106 family physicians and 13 pulmonologists and allergists took part in this study. Each doctor had selected 10–15 asthma patients and had sent invitations to them by post. On the visit day, the patients themselves filled in the Asthma Control Test. The doctors interviewed the patients and filled in a special questionnaire. Pulmonologists and allergists also assessed lung function by performing spirometry. According to the results of the Asthma Control Test, the disease control level was indicated as “totally controlled” (25 points), “well controlled” (24–20 points), and “uncontrolled” (19 points or less).

Results. A total of 876 asthma patients were examined. Uncontrolled asthma was diagnosed to 56.2% of the patients, 36.5% of patients had well controlled and 7.3% totally controlled asthma. There was no significant difference in asthma control level comparing men and women. A correlation between asthma control level and age was found revealing poorer asthma control in older patients. Ninety-five percent of patients were treated with inhaled steroids; most of them had used inhaled steroids in combination with long-acting β₂ agonists. It was found that lung function correlated with clinical symptoms of asthma, the demand of short-acting β₂ agonists, and asthma control level.

Conclusion. The study showed that uncontrolled asthma was diagnosed to more than half of the patients, despite most of them used inhaled steroids. Asthma control was worsening with the age of patients with asthma and it correlated with lung function. We suggest that periodical assessment of asthma control should help to optimize asthma management.

Correspondence to G. Pilkauskaitė, Department of Pulmonology and Immunology, Kaunas University of Medicine, Eivenių 2, 50009 Kaunas, Lithuania. E-mail: guodyte@yahoo.com

Received 26 January 2009, accepted 7 December 2009