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One in four mild asthma patients lack control despite skipping preventers

A Swedish study of nearly 300 patients found that 26% with mild asthma experience poor disease control and 40% report compromised quality of life—even though they use no daily preventive medication. The findings suggest current treatment guidelines may underestimate the burden of disease in this population and point to potential gaps in clinical care.

Originaltitel: Risk Factors Associated with Asthma Control and Quality of Life in Patients with Mild Asthma Without Preventer Treatment: a Cross-Sectional Study

Abstrakt

<p>Purpose: To study risk factors for uncontrolled asthma and insufficient quality of life (QoL) in patients with mild asthma, ie those without preventer treatment.</p><p>Patients and Methods: Patients aged 18-75 years with a doctor's diagnosis of asthma randomly selected from primary and secondary care in Sweden. Mild asthma was defined as self-reported current asthma and no preventer treatment. Data were collected from self-completed questionnaires in 2012 and 2015. Well-controlled asthma was defined as Asthma Control Test (ACT) &gt;20 points and no exacerbation and uncontrolled asthma as ACT&lt;20 points and/or at least one exacerbation in the previous six months. QoL was measured by the Mini Asthma Quality of Life Questionnaire (Mini-AQLQ), where a total mean score of &gt; 6 indicated sufficient and &lt; 6 insufficient QoL. Multivariate logistic regression analyses were performed using asthma control and Mini-AQLQ as dependent variables. Asthma control was dichotomized as controlled and uncontrolled asthma and the Mini-AQLQ as sufficient QoL (mean score &gt;6) and insufficient QoL (mean score &lt;6).</p><p>Results: Among 298 patients, 26% had uncontrolled asthma, 40% insufficient QoL and 20% both uncontrolled asthma and insufficient QoL. Age &gt;60 years, obesity, daily smoking, rhinitis and inadequate knowledge of asthma self-management were independently associated with poor asthma control. Factors independently associated with insufficient QoL were age &gt;60 years, overweight, obesity, rhinitis, sinusitis and inadequate knowledge of asthma self-management. Age &gt;60 years, obesity, rhinitis and inadequate knowledge of asthma self-management were independently associated with both uncontrolled asthma and insufficient QoL.</p><p>Conclusion: Among asthma patients without preventer medication, 26% had uncontrolled asthma and 40% had insufficient asthmarelated QoL. Older age, obesity, and rhinitis were risk factors for both poor asthma control and a reduced QoL, but having good knowledge of asthma self-management reduced this risk. Our findings suggest that this group of patients requires further attention and follow-up.</p>

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