BACKGROUND: Many patients have asthma that is inadequately controlled, contributing to significant morbidity and burden to patients and caregivers.
OBJECTIVES: Identify risk factors for uncontrolled asthma in pediatric and adult asthma patients.
METHODS: Two parallel cross-sectional surveys were conducted in 35 adult and 29 pediatric primary care practices in the United States (US). Participants included 2,238 adults (aged ≥ 18 years) and 2,429 children (aged 4-17 years; and their caregivers) with asthma, visiting their health care provider for a scheduled appointment for any reason. A standardized assessment of asthma control, including questions about possible characteristics related to asthma control, was completed. Uncontrolled asthma was defined as a score of ≤ 19 on the Asthma Control Test™ (ACT) or Childhood ACT. Unconditional multivariable logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals for predictors of uncontrolled asthma.
RESULTS: Prevalence of uncontrolled asthma was 58% in adults and 49% in children. Common self-reported independent predictors (OR > 1.5) of uncontrolled asthma in both adults and children were asthma severity rated as moderate or severe and recent history of cold, flu, or sinus infection. Independent predictors of uncontrolled asthma seen only in adults were current smoker, education level less than college, Medicaid insurance, and body mass index (BMI) > 30. Independent predictors of uncontrolled asthma seen in only children were female gender in those aged 12 to 17 years and caregiver unemployment.
CONCLUSIONS: Uncontrolled asthma is common in patients with asthma seen in primary care settings. This study may help identify specific risk factors and target patients who may be at increased risk for uncontrolled asthma.
