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. 2023 May 2;6(5):e1021.
doi: 10.1002/hsr2.1021. eCollection 2023 May.

Asthma control and care among six public health clinic attenders in Malaysia: A cross-sectional study

Norita Hussein  1 , Su May Liew  1 , Nik Sherina Hanafi  1 , Ping Yein Lee  2 , Ai Theng Cheong  3 , Sazlina Shariff Ghazali  3 , Karuthan Chinna  4 , Yong Kek Pang  5 , Asiah Kassim  6 , Richard A Parker  7 , Jürgen Schwarze  8   9 , Aziz Sheikh  8 , Hilary Pinnock  8 , Ee Ming Khoo  1 ; RESPIRE Collaborators
Affiliations

Asthma control and care among six public health clinic attenders in Malaysia: A cross-sectional study

Norita Hussein et al. Health Sci Rep. .

Abstract

Background and aims: Asthma is common in Malaysia but neglected. Achieving optimal asthma control and care is a challenge in the primary care setting. In this study, we aimed to identify the risk factors for poor asthma control and pattern of care among adults and children (5-17 years old) with asthma attending six public health clinics in Klang District, Malaysia.

Methods: We conducted a cross-sectional study collecting patients' sociodemographic characteristics, asthma control, trigger factors, healthcare use, asthma treatment, and monitoring and use of asthma action plan. Descriptive statistics and stepwise logistic regression were used in data analysis.

Results: A total of 1280 patients were recruited; 85.3% adults and 14.7% children aged 5-17 years old. Only 34.1% of adults had well-controlled asthma, 36.5% had partly controlled asthma, and 29.4% had uncontrolled asthma. In children, 54.3% had well-controlled asthma, 31.9% had partly controlled, and 13.8% had uncontrolled asthma. More than half had experienced one or more exacerbations in the last 1 year, with a mean of six exacerbations in adults and three in children. Main triggers for poor control in adults were haze (odds ratio [OR] 1.51; 95% confidence interval [CI] 1.13-2.01); cold food (OR 1.54; 95% CI 1.15-2.07), extreme emotion (OR 1.90; 95% CI 1.26-2.89); air-conditioning (OR 1.63; 95% CI 1.20-2.22); and physical activity (OR 2.85; 95% CI 2.13-3.82). In children, hot weather (OR 3.14; 95% CI 1.22-8.11), and allergic rhinitis (OR 2.57; 95% CI 1.13-5.82) contributed to poor control. The majority (81.7% of adults and 64.4% of children) were prescribed controller medications, but only 42.4% and 29.8% of the respective groups were compliant with the treatment. The importance of an asthma action plan was reported less emphasized in asthma education.

Conclusion: Asthma control remains suboptimal. Several triggers, compliance to controller medications, and asthma action plan use require attention during asthma reviews for better asthma outcomes.

Keywords: asthma; asthma control; primary care; risk factors.

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Conflict of interest statement

Ee Ming Khoo, Ping Yein Lee, Ai Theng Cheong, Hilary Pinnock and Aziz Sheikh report grants from the National Institute for Health Research (NIHR) Global Health Research Unit on Respiratory Health (RESPIRE). Ee Ming Khoo reports personal fees from AstraZeneca; and is the President of the International Primary Care Respiratory Group and the Primary Care Respiratory Group Malaysia. Yong Kek Pang is the President of the Malaysian Thoracic Society and advisory committee for Novartis, AstraZeneca and Boehringer Ingelheim. Aziz Sheikh reports on grants from Asthma UK and HDR UK. All other authors declare no conflicts of interests. The National Institute for Health Research (NIHR) Global Health Research Unit on Respiratory Health (RESPIRE) funded this study, however, there is no direct involvement of decision in study design; collection, analysis, and interpretation of data; writing of the report except needing their approval to report for publication. For other financial bodies, there is no involvement. All authors have read and approved the final version of the manuscript. Honorary Professor Dr. Ee Ming Khoo (corresponding author) has full access to all of the data in this study and takes complete responsibility for the integrity of the data and the accuracy of the data analysis. The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR or the UK Department of Health and Social Care.

References

    1. Wong GWK, Leung TF, Ko FWS. Changing prevalence of allergic diseases in the Asia‐Pacific region. Allergy, Asthma Immunol Res. 2013;5:251‐257. - PMC - PubMed
    1. Ahad A, Ming Khoo E. Asthma control and care among Malaysian primary school children: a cross‐sectional study. Asia Pac J Public Health. 2017;29:422‐429. - PubMed
    1. Pearce N, Ait‐Khaled N, Beasley R, et al. Worldwide trends in the prevalence of asthma symptoms: phase III of the International Study of Asthma and Allergies in Childhood (ISAAC). Thorax. 2007;62(9):758‐766. - PMC - PubMed
    1. Chan YY, Teh CH, Lim KK, et al. Lifestyle, chronic diseases and self‐rated health among Malaysian adults: results from the 2011 National Health and Morbidity Survey (NHMS). BMC Public Health. 2015;15(1):754. - PMC - PubMed
    1. Bahadori K, Doyle‐Waters MM, Marra C, et al. Economic burden of asthma: a systematic review. BMC Pulm Med. 2009;9(1):24. - PMC - PubMed

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