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"Severe-controlled" asthma 4 years later: is it still controlled?
Shabtai Varsano1,2,3, Lilach Israeli1, David Shitrit1,2
1Department of Pulmonary Medicine, Meir Medical Center, Kfar Saba, Israel.
Summary
Even with regular medication, severe asthma patients may not have optimal control or quality of life. Addressing asthma control through validated questionnaires and education is crucial for better patient outcomes.
Area of Science:
- Pulmonary Medicine
- Allergy and Immunology
Background:
- Controlled severe asthma is defined by regular medication and four markers of good control.
- This study re-evaluated a cohort previously identified as "severe-controlled" based on electronic medical records.
Purpose of the Study:
- To determine the current clinical control and quality of life in patients previously classified as "severe-controlled" asthma.
- To assess long-term asthma control and associated factors in a community sample.
Main Methods:
- A cohort of 69 patients previously identified as "severe-controlled" completed a questionnaire assessing asthma control (Asthma Control Test - ACT), comorbidities, and quality of life.
- Patients underwent spirometry, eosinophil counts, total IgE measurement, and skin-prick testing for airborne allergens.
Main Results:
- 97% used inhaled corticosteroid/long-acting beta-agonist (ICS/LABA) inhalers regularly, with low emergency room visits (4%) and no hospitalizations.
- Average predicted FEV1 was 80%, with an average ACT score of 19, indicating suboptimal control.
- High prevalence of comorbidities like heartburn (51%) and rhinitis (70%) was observed; 42% had eosinophil counts ≥300/ml, and 25% had counts ≥400/ml.
Conclusions:
- Good medication adherence and low exacerbation rates do not guarantee optimal asthma control or quality of life.
- Physicians and healthcare organizations should prioritize quality of life in asthma management using validated questionnaires.
- Asthma education is recommended for all patients, with particular attention to those with lower levels of formal education.
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