Demographic and medical factors affecting short-term changes in subjective evaluation of asthma control in adolescents

Abstract

Introduction: Asthma control is an important measure of disease stabilization, which is linked to the treatment and lifestyle recommendations.

Aim: To assess the impact of selected factors on asthma control in adolescents, as assessed using the Asthma Control Test (ACT™).

Material and methods: The prospective study included 100 asthma patients aged between 12 and 19. Asthma was assessed in three consecutive follow-up visits spaced 3 months apart, using the standardized ACT™ questionnaire.

Results: Asthma was fully controlled (ACT score = 25 points) in more than half of the patients in all follow-up visits (53.0%, 54.0%, and 56.0%, respectively). More than one third of the participants scored between 20 and 24 points (37.0% vs. 39.0% vs. 40.0%). A minority of patients had uncontrolled asthma (scores below 20), and the group consistently diminished in subsequent visits (10% vs. 7% vs. 4%). Uncontrolled asthma was found significantly more often in female patients (33.33%; p < 0.001) and those living in rural areas (20.59%; p < 0.01). Treatment with a combination of inhaled corticosteroids (ICS) and LABAs was associated with worse asthma control (14.81%; p < 0.05). Better asthma control was found in patients with a family history of allergies (73.85% vs. 75.38% vs. 78.46%; p < 0.001) and in those with concurrent allergies (66.67% vs. 68.00% vs. 70.67%; p < 0.001).

Conclusions: Asthma control in adolescents differs by sex and residence. Concurrent allergies and family history of allergies improve asthma self-control in adolescents.

Keywords: Asthma Control Test; adolescents; asthma; asthma control.

Figure 1

Study group selection process

Figure 2

Medical considerations (A – treatment methods, B – allergen immunotherapy, C – concurrent allergic rhinitis and atopic dermatitis, D – asthma phenotype, E – family history of atopy) and asthma control assessed using the ACT