Factors Influencing Disease Control in Patients with Asthma
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Abstract
Purpose: This research aimed to study the influences of depression, adherence to inhaled corticosteroids, smoking and comorbidity on disease control in patients with asthma.
Design: Correlational predictive research.
Methods: The subjects comprised 130 patients aged 18 years and older with asthma who received inhaled corticosteroids at least 3 months and came for follow-up visits at the Asthma Clinic of one tertiary hospital in Bangkok, Thailand. The subjects were recruited by conveniene sampling. Data were collected by questionnaires on demography, the Level of Asthma Control according to Global Initiative for Asthma (GINA) criteria, the Center for Epidemiological Studies Depression Scale, the Medication Adherence Report Scale and the Charlson Comorbidity Index. Data were analyzed using descriptive statistics and enter method logistic regression analysis.
Main findings: Two-thirds of the subjects were females (66.6%) with a mean age of 63 years (SD = 12.7). More than half (54.6%) had uncontrolled asthma. Fourteen percent had developed depression. The subjects (54.6%) had adherence to inhaled corticosteroids. One-fourths (25.4%) were smokers. Most of the subjects (93.8%) had comorbidities and almost half (47.7%) had a low level of comorbidities. Depression, adherence to inhaled corticosteroids, smoking, and comorbidity were able to predict disease control in patients with asthma at 21.4 percent (Nagelkerke R2 = .214). Depression and adherence to inhaled corticosteroids were able to predict with statistical significance (OR = 19.13, 95%CI = 2.37, 154.64 and OR = 2.21, 95%CI = 1.03, 4.78, respectively).
Conclusion and recommendations: Depression and adherence to inhaled corticosteroids were manageable factors could affect with asthma control. Nurses and healthcare teams should pay attention to assessing depression and adherence to inhaled corticosteroids in order to prevent or manage depression and development of a nursing care program for increasing adherence to inhaled corticosteroids, which can lead to improved disease control in patients with asthma.
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