The Evaluation of Asthma Control and its Predictors in Patients Attending a Tertiary Clinic in Lagos, Nigeria

Abstract

Background: There is a high rate of poorly controlled asthma in Nigeria. The determination of the level of asthma control and associated factors in asthma patients attending clinics is important to identify those patients at risk of exacerbations. The objective of this study is to evaluate the level of asthma control of patients attending respiratory clinic in Lagos using the Asthma Control Test (ACT) and pre-forced expiratory volume in first second (PREFEV1).

Methodology: This was a cross-sectional descriptive study. The ACT questionnaire and PREFEV1 were used to assess asthma control of patients attending a tertiary pulmonary clinic in Lagos. Two hundred patients were recruited over the period of one year between 2016 and 2017.

Results: The participants comprised of 96 (48.0%) females and 104 (52.0%) males with mean and standard deviation (SD) of 40.57± 15.86 years. The mean score with standard deviation of the ACT score was 18.64 +4.64. Half of the participants had good asthma control (>20) based on the ACT score. The mean pre FEV1 was 2.14 +0.93 for 200 participants and the post FEV1 of 189 was 2.25+ 0.91. Only76 (37.5%) participants had normal FEV1. About one third of the participants 60(30%) had obstructive ventilatory pattern, 9(5%) had restrictive ventilatory pattern, 73(37%) had mixed ventilator pattern and 58(29%) had normal ventilatory pattern. Allergic rhinitis was reported in 99 (49.5%) and likelihood of GERD in 63 (31.5%). There was a significant positive relationship between the ACT and FEV1 and a significant negative relationship between the GSAS score and ACT (p= <0.0001 and p= <0.0001 respectively).

Conclusion: The level of asthma control using ACT questionnaire was average among asthma patients attending the clinic. However, the use of pre FEV1 which is an objective tool for assessing asthma control was significantly lower among these patients. The use of Lung function test should be employed in respiratory clinics for objective assessment of patients' asthma control in other to achieve the goals of asthma treatment.

Keywords: Asthma; Asthma Control; Asthma Control Test; PREFEV1; Reversibility; Spirometry.