Asthma Treatment Outcome and Factors Associated with Uncontrolled Asthma Among Adult Patients with Asthma in Addis Ababa, Ethiopia

Abstract

Background: Asthma is a major public health challenge in the world resulting in significant health and economic burden. The modifiable and non-modifiable risk factors could have considerable impact on asthma control and medical care. Objective: This study is intended to evaluate the treatment outcome and identify risk factors for poor asthma control among patients with asthma in Addis Ababa, Ethiopia. Methods: A multicentre cross-sectional study using interview and chart review was conducted among patients with asthma attending ambulatory care of two large public hospitals in Addis Ababa, Ethiopia, between March and June 2018. The Global Initiative for Asthma Guideline was used to determine treatment outcomes. The variables of interest were described using descriptive statistics such as frequencies, percentages, mean, and standard deviations. Multivariable logistic regression was used to determine factors associated with uncontrolled asthma. All statistical significance level was determined at p < 0.05. Results: A total of 230 patients with asthma were interviewed. More than half (65.2%) of patients were females, and their mean age was 54 ± 15.1 years. Overall, 50.4% of the patients had uncontrolled asthma status. More than two number of trigger factors (AOR = 1.88; 95% CI: 1.09–2.01), cold weather (AOR = 2.11; 95% CI: 1.51–2.42), exacerbations of asthma in the last 12 months (AOR = 2.01; 95% CI: 1.39– 2.32), moderate persistent asthma (AOR = 3.47; 95% CI: 1.75–5.13), severe persistent asthma (AOR = 2.90; 95% CI: 2.56–3.98), patients on Salbutamol puff with Beclomethasone (AOR = 2.92; 95% CI: 2.50–3.45) and patients on Salbutamol puff with Beclomethasone and Prednisolone (AOR = 5.76; 95% CI: 4.02–6.02) use were significantly associated with uncontrolled asthma. Conclusion: More than half of patients with asthma had uncontrolled asthma treatment outcome. This indicates the need to give due attention to asthma patients with uncontrolled status, particularly to those with identified risk factors. Health care providers should work in creating patient awareness on appropriate use of their prescribed medications, avoidance of asthma triggering factors for decreasing the progression of the disease and better asthma control.