Evaluation of the prevalence of anxiety and depression and the impact of asthma control level on these parameters among asthmatic patients

Abstract

Objectives: This study is designed to assess the prevalence of anxiety and depression among asthmatic patients living in Amman, Jordan. Additionally, it evaluates the effect of asthma control levels using the correct inhaler technique on anxiety and depression. Method: This single-blinded, randomized, interventional, active-control study was conducted at the University of Jordan Hospital in the period between March and August of 2019. Asthmatic patients in the active group were counseled on the correct inhaler technique using placebo inhalers and using sticky labels on their prescribed inhalers. At the baseline and after three months, both groups were assessed on their asthma level of control, anxiety and depression using the asthma control test (ACT), general anxiety disorder (GAD-7) and patient health questionnaire (PHQ-9), respectively. A total of 159 asthmatic adult patients were recruited and randomized into active groups (n = 79) and control groups (n = 78) using controller inhalers, either Turbohaler or Accuhaler or both. Results: ACT, GAD7, and PHQ9 were assessed at the baseline and no statistically significant difference between both groups was found (P-value < 0.001). At follow-up, ACT, GAD7, and PHQ9 showed significant differences in the active group with mean ± SD of 21.21±5.26, (P-value < 0.001), 3.84 ±4.782, (P-value < 0.001), 6.4±6.4115, (P-value < 0.001), respectively. At the same time, the difference in the mean score for control group patients did not reach a significant level. Conclusion: The prevalence of psychological disorders among asthmatic patients is common and directly related to the asthma level of control. Improvements in the ACT can lead to significant improvements in patient anxiety and depression related to asthma.