Associated factors of asthma exacerbation in Bangkhla hospital, Thailand
Article Sidebar
Main Article Content
Abstract
Background Asthma is a chronic inflammatory disease of the airways that leads to disability and mortality. There is still limited evidence on associated factors of hypertension in Thailand.
Methods The study is a retrospectively cross-sectional study of asthmatic patients aged at least 3 years attending a first-level referral (F2) hospital, Bangkhla hospital, in Chachoengsao province, Thailand from January 2015 – September 2018. We included patients who were diagnosed with asthma by ICD-10 codes as J45-J46 and prescribed asthma-related medications on at least two outpatient visits or systemic corticosteroids on one outpatient visit. Asthma exacerbation was defined as requiring emergency visit to receive a bronchodilator and a corticosteroid or requiring hospitalization or referral to high-level referral hospital. Data was collected by reviewing both electrical and nonelectrical medical records. Finally, the total data will be analysed by SPSS 22.0.
Result A total of 258 patients with asthma were included in this study. We took various factors into chi-square and found that statistically significant, age, sex, smoker, hypertension, dyslipidemia, loss of follow-up, and MPR were associated with asthma exacerbation. We found an association between at least 2 ED visits per year and MPR (Adjusted OR = 2.563, 95% CI 1.18-5.568), and loss-to-follow-up more than 2 times per year (Adjusted OR = 2.684, 95% CI 1.081-6.664). Furthermore, both MPR and the number of loss-to-follow-up times were found to significantly increase the risk of hospitalization showing an adjusted ORs of 3.821 (95% CI 1.728-8.452) and 4.404 (95% CI 1.619-11.982), respectively.
Conclusion In this study, the associated factors with asthma exacerbation were lower MPR value and the number of loss-to-follow-up times. Thus, we suggest that physicians should emphasise patients to regularly take medication and follow up.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
To T, Stanojevic S, Moores G, Gershon AS, Bateman ED, Cruz AA, Boulet LP. Global asthma prevalence in adults: findings from the cross-sectional world health survey. BMC Public Health. 2012 Mar 19;12:204. doi: 10.1186/1471-2458-12-204. Erratum in: BMC Public Health. 2021;21(1):1809.
Osborne ML, Pedula KL, O'Hollaren M, Ettinger K, Stibolt T, Buist AS, et al. Assessing Future Need for Acute Care in Adult Asthmatics: The Profile of Asthma Risk Study: A Prospective Health Maintenance Organization-Based Study. Chest. 2007:1151-61.
Al-Jahdali H, Ahmed A, Al-Harbi A, Khan M, Baharoon S, Bin Salih S, et al. Improper inhaler technique is associated with poor asthma control and frequent emergency department visits. Allergy Asthma Clin Immunol. 2013;9(1):8.
Stern L, Berman J, Lumry W, Katz L, Wang L, Rosenblatt L, et al. Medication compliance and disease exacerbation in patients with asthma: a retrospective study managed care data. Ann Allergy Asthma Immunol. 2006;97(3):402-8.
Sanya RE, Kirenga BJ, Worodria W, Okot-Nwang M. Risk factors for asthma exacerbation in patients presenting to an emergency unit of a national referral hospital in Kampala, Uganda. African Health Sciences. 2014;14(3):707-15.
Brinke AT, Sterk PJ, Masclee AAM, Spinhoven P, Schmidt JT, Zwinderman AH, et al. Risk factors of frequent exacerbations in difficult-to-treat asthma. Eur Respir J. 2005 ;26(5):812-8.
Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A, et al. Allergic rhinitis and its impact on asthma (ARIA) 2008 update (in collaboration with the world health organization). Allergy. 2008 ;63(Suppl 86):8-160.
Fitzpatrick S, Joks R, Silverberg JI. Obesity is associated with increase asthma severity and exacerbations, and increased serum immunoglobulin E in inner-city adults. Clin Exp Allergy. 2012 ;42(5):747-59.
Park H, Byun M, Kim H, Ahn C, Rhee C, Kim K, et al. Regular follow‑up visits reduce the risk for asthma exacerbation requiring admission in Korean adults with asthma. Allergy Asthma Clin Immunol. 2018:14:29.
Kang H, Song H, Nam J, Hong S, Yang S, Ju S, et al. Risk factors of asthma exacerbation based on asthma severity: a nationwide population-based observational study in South Korea. BMJ Open. 2018;8(3):e020825.
Redzuan AM, Lee MS, Shah NM. Adherence to preventive medications in asthmatic children at a tertiary care teaching hospital in Malaysia. DovePress. 2014;8:263-70.
Badder S, Jayakrishnan B, Al-Rawas OA. Asthma control: importance of compliance and inhaler technique assessments. J Asthma. 2014;51(4):429-34.
Lycett H, Wildman E, Raebel E, Sherlock J-P, Kenny T, Chan A. Treatment perceptions in patients with asthma: Synthesis of factors influencing adherence. Respir Med. 2018:180-9.
Baren JM, Shofer FS, Ivey B, Reinhard S, DeGeus J, Stahmer SA, et al. A randomized controlled trial of a simple emergency department intervention to improve the rate of primary care follow-up for patients with acute asthma exacerbation. Ann Emerg Med. 2001;38(2):115-22.
Smith SR, Jaffe DM, Highstein G, Fisher EB, Trinkaus KM, Strunk RC. Asthma coaching in the pediatric emergency department. Acad Emerg Med. 2006;13(8):835-9.
Villa-Roel C, Nikel T, Ospina M, Voaklander B, Campbell S, Rowe BH. Effectiveness of Educational Interventions to Increase Primary Care Follow-up for Adults Seen in the Emergency Department for Acute Asthma: A Systematic Review and Meta-analysis. Acad Emerg Med. 2016 ;23(1):5-13.