Predictive parameters of uncontrolled asthma in the real world: a prospective study

The ultimate goal of asthma management is to have complete control of the condition, yet the number of patients with uncontrolled asthma continues to rise. This study aims to determine the prevalence of uncontrolled asthma, identify predictive parameters, and compare MART and non-MART treatment regimes.

A prospective questionnaire was administered to 495 patients who signed the consent form. According to the scores obtained from the Asthma control test (ACT), patients were grouped into Group 1 (ACT score ≤ 19): Uncontrolled Asthma and Group 2 (ACT score > 19): Well-Controlled Asthma. Treatment adherence was evaluated by using the Morisky Medication Adherence Scale (MMAS).

The proportion of patients with uncontrolled asthma was found to be 54.9%. Effective predictors of uncontrolled asthma were female gender (OR = 1.7, 95% CI 1.1-2.7, p = 0.023), FEV₁/FVC%<93% (OR = 2.5, 95% CI 1.5-4.1, p < 0.001), a history of visits to the emergency department during the previous year (OR = 2.7, 95% CI 1.7-4.3, p < 0.001), and receiving non-MART treatment (OR = 2.0, 95% CI 1.3-3.1, p = 0.001). MMAS was found to be higher, and medication adherence lower, in uncontrolled asthma patients (p = 0.040). The MART treatment regimen was preferred in 36% of cases. In the MART treatment group, as compared to the non-MART treatment group, uncontrolled asthma (43.8% vs. 61.2%) was observed according to ACT (p < 0.001).

The risk of uncontrolled asthma was found to be higher in female patients, or those who had visited the emergency department, had been hospitalized within the past year, had poor pulmonary function test results or low treatment compliance, and who were on non-MART treatment regimens.