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[Descriptive analysis (clinical and functional characteristics) of an asthmatic population in a health care district]
M J Espinosa de los Monteros1, A González, F Rodríguez
1Servicio de Neumología, Hospital Universitario de la Princesa de Madrid.
Objective:
To determine the social, demographic, clinical and lung function characteristics of the population of asthmatics living in Health Care District 2 of Madrid.
Study Design:
Transversal (initial visit) phase of a primary care community intervention study. The target population consisted of all asthmatics in District 2 of Madrid who were registered at the public health clinics, were older than 14 and had experienced asthma symptoms within the past year. The selection of patients for the study was systematic (not probabilistic), such that all registered asthmatics seeking care and/or scheduled for check-ups were enrolled. Participation was 96.6% of those on file. We recorded social, demographic, clinical, and lung function variables as well as results of allergy studies, family histories of asthma and/or atopy and type of treatment.
Results:
Six hundred fifty patients were enrolled, 238 men (36.7%) and 412 women (63.3%). Mean age was 45 +/- 28.1 yr, mean FEV1% was 87.2 +/- 26%. Mean course of disease was 16 +/- 14.6 yr and age of onset was 26 +/- 20 yr. Family history of asthma was present in 34% of cases and a family history of atopy was reported by 21%. Half had allergic rhinitis as an associated factor, with respiratory infections (62.4%) being the most common trigger, followed by pollen (25.3%) and exposure to tobacco smoke (20%). Active smokers accounted for 9.1% of the group, and ex-smokers for 21.6%. Short-term beta-adrenergic drugs on demand were used by 64% of patients, whereas 83.2% reported daily and long-term use of beta-2 drugs and 77% used inhaled steroids. Severity of disease differed significantly by age of patient, age at onset and predominance of perennial asthma (with older age and age of onset and greater seasonality observed among severely asthmatic patients).
Conclusions:
a) Most symptomatic asthmatic have mild disease. b) Rationally adjusted, appropriate drug treatment should be graded according to level of disease severity.