Detection Of Treatment Adherence, Disease Control and Its Predictors in Asthma Patients by Rural Community Level Health Workers

Authors

  • Prianka Mukhopadhyay Bankura Sammilani Medical College, Bankura, West Bengal, India
  • Sumanta Chakraborty Diamond Harbour Government Medical College & Hospital, Harindanga, Diamond Harbour, West Bengal, India
  • Manisha Sarkar Bankura Sammilani Medical College, Bankura, West Bengal, India https://orcid.org/0000-0002-6265-9180

DOI:

https://doi.org/10.55489/njcm.130820222101

Keywords:

Asthma control, Asthma Control Test, Bronchial Asthma, Medication adherence, Prevention and control, Risk factors

Abstract

Background: Despite the availability of effective therapy, disease control in Asthma remains suboptimal with high morbidity.

Objectives: To assess treatment adherence, asthma control and its influencing factors.

Methodology: A prospective, observational study was conducted among 152 adult asthma patients reporting consecutively to a BPHC for twelve months. Patients were followed up by trained healthcare workers to assess their treatment adherence and disease control using a predesigned, pretested and validated questionnaire.

Results: Mean age was 49.6 years (SD = +14.0), males reported more cases (73.7%), addiction to tobacco was high (48.7%). 40.8% patients had high treatment adherence. Only 37.5% patients reported good asthma control of which 68.4% showed high adherence. The mean Asthma Control Test (ACT) score was 18.75 ± 4.8 SD. Increasing age (aOR=0.96, 95% CI= 0.93-0.99), tobacco smoking (aOR=2.90, 95% CI=1.20-6.99), dust allergy (aOR= 7.92, CI =3.15-19.91) and low treatment adherence (aOR=5.33, 95% CI=2.22-12.82) were found to be significant predictors of poor disease control.

Conclusions: Non adherence to treatment and poor disease control were high among rural asthma patients. Patient education for tobacco cessation and treatment compliance along with periodic monitoring undertaken by trained health workers can be an effective strategy to reduce disease burden in the community.

References

Bousquet J, Kaltaev N‎. Global surveillance, prevention and control of chronic respiratory diseases: a comprehensive approach / ed-ited by Jean Bousquet and Nikolai Khaltaev [Internet]. Switzerland: World Health Organization; 2007 [cited 2022 May 20]. Available from: https://apps.who.int/iris/handle/10665/43776.

Aggarwal AN, Chaudhry K, Chhabra SK, et al. Prevalence and risk factors for bronchial asthma in Indian adults: a multicentre study. Indian J Chest Dis Allied Sci [Internet]. 2006 Jan-Mar [cited 2022 Jul 15];48(1):13-22. Available from: https://pubmed.ncbi.nlm.nih.gov/16482947/

Engelkes M, Janssens HM, de Jongste JC, et al. Medication adherence and the risk of severe asthma exacerbations: a systematic re-view. Eur Respir J [Internet]. 2015 Feb [cited 2022 Jul 15];45(2):396-407. Doi; https://doi.org/10.1183/09031936.00075614 PMid:25323234

Mohd Isa NA, Cheng CL, Nasir NH, et al. Asthma control and asthma treatment adherence in primary care: results from the prospec-tive, multicentre, non-interventional, observational cohort ASCOPE study in Malaysia. Med J Malaysia [Internet]. 2020 Jul [cited 2022 Jul 15];75(4):331-7. Available from: https://pubmed.ncbi.nlm.nih.gov/32723990/

India State-Level Disease Burden Initiative CRD Collaborators. The burden of chronic respiratory diseases and their heterogeneity across the states of India: the Global Burden of Disease Study 1990-2016. Lancet Glob Health [Internet]. 2018 Dec [cited 2022 Jul 15];6(12):e1363-74. Doi: https://doi.org/10.1016/S2214-109X(18)30409-1

Lourenço O, Calado S, Sá-Sousa A, et al. Evaluation of allergic rhinitis and asthma control in a Portuguese community pharmacy set-ting. J Manag Care Spec Pharm [Internet]. 2014 May [cited 2022 Jul 15];20(5):513-22. Doi: https://doi.org/10.18553/jmcp.2014.20.5.513 PMid:24761823

Ghanname I, Chaker A, Cherkani Hassani A, et al. Factors associated with asthma control: MOSAR study (Multicenter Observational Study of Asthma in Rabat-Morocco). BMC Pulm Med[Internet]. 2018 Apr 24 [cited 2022 Jul 15];18(1):61. Doi: https://doi.org/10.1186/s12890-018-0624-6 PMid:29699541 PMCid:PMC5921326

Albataineh E, Al-Zayadneh E, Al-Shagahin H, et al. Asthma Control and Its Predictive Factors in Adult Asthma Patients. J Clin Med Res [Internet]. 2019 Dec [cited 2022 Jul 15];11(12):807-17. Available from: https://doi.org/10.14740/jocmr4021. Erratum in: J Clin Med Res [Internet]. 2020 Feb [cited 2022 Jul 15];12(2):127. Doi: https://doi.org/10.14740/jocmr4021c1 PMid:32095183 PMCid:PMC7011937

Kotwani A, Chhabra SK, Tayal V, et al. Quality of asthma management in an urban community in Delhi, India. Indian J Med Res[Internet]. 2012 [cited 2022 Jul 15];135(2):184-92. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3336849/?report=classic

Ribó, P, Molina J, Calle, M, Maiz L, Campo C, Rytila P et al. Prevalence of modifiable factors limiting treatment efficacy of poorly con-trolled asthma patients: EFIMERA observational study. npj Prim. Care Respir. Med [Internet]. 2020 [cited 2022 Jul 16];30:1-8. Doi: https://doi.org/10.1038/s41533-020-00189-6 PMid:32737324 PMCid:PMC7395116

Zuiani C, Custovic A. Update on House Dust Mite Allergen Avoidance Measures for Asthma. Curr Allergy Asthma Rep [Internet]. 2020 Jun 19 [cited 2022 Jul 15];20(9):50. Doi: https://doi.org/10.1007/s11882-020-00948-y PMid:32561997 PMCid:PMC7305068

Okasha, N.M., Sarhan, A.A. & Ahmed, E.O. Association between house dust mites sensitization and level of asthma control and severi-ty in children attending Mansoura University Children's Hospital. Egypt J Bronchol [Internet]. 2021 [cited 2022 Jul 16];15:1-7. Doi: https://doi.org/10.1186/s43168-021-00082-x

Accordini S, Calciano L, Johannessen A et al. Ageing Lungs in European Cohorts (ALEC) Study. A three-generation study on the asso-ciation of tobacco smoking with asthma. Int J Epidemiol [Internet]. 2018 Aug 1 [cited 2022 Jul 15];47(4):1106-17. Doi: https://doi.org/10.1093/ije/dyy031 PMid:29534228 PMCid:PMC6124624

Spears M, Cameron E, Chaudhuri R, et al. Challenges of treating asthma in people who smoke. Expert Rev Clin Immunol [Internet]. 2010 [cited 2022 Jul 15];6(2):257-68. Doi: https://doi.org/10.1586/eci.09.85 PMid:20402388

Patel NS, Christian DS, Kamdar DJ, Patel KR. Treatment adherence related to asthma patients of a tertiary care institute. Indian J Comm Health [Internet]. 2018 [cited 2022 Jul 16];30(2):127-32. Available from: https://www.iapsmupuk.org/journal/index.php/IJCH/article/view/854 Doi: https://doi.org/10.47203/IJCH.2018.v30i02.006

Aggarwal D, Bhardwaj M, Singh B, Janmeja AK. Factors Determining Adherence to Inhaled Corticosteroids in Bronchial Asthma Pa-tients at a Tertiary Care Hospital in India. J Clin Diagn Res [Internet]. 2017 Dec [cited 2022 Jul 16];11(12):OC14-18. Doi: https://doi.org/10.7860/JCDR/2017/32568.10988

Rafi, MA, Tahmin, CI, Tashrik, S, Bonna AS, Jannat F, Mily SJ et al. Adherence to inhalers and associated factors among adult asthma patients: an outpatient-based study in a tertiary hospital of Rajshahi, Bangladesh. Asthma Res and Pract [Internet]. 2022 Feb 9 [cit-ed 2022 Jul 16];8(1):1-8. Doi: https://doi.org/10.1186/s40733-022-00083-7 PMid:35139927 PMCid:PMC8827279

Smits D, Brigis G, Pavare J, et al. Factors related to good asthma control using different medical adherence scales in Latvian asthma patients: an observational study. NPJ Prim Care Respir Med [Internet]. 2017 Jun 20 [cited 2022 Jul 15];27(1):39. Doi: https://doi.org/10.1038/s41533-017-0042-x PMid:28634371 PMCid:PMC5478625

Neffen H, Chahuàn M, Hernández DD, et al. Key factors associated with uncontrolled asthma - the Asthma Control in Latin America Study. J Asthma [Internet]. 2020 Feb [cited 2022 Jul 15];57(2):113-22. Doi: https://doi.org/10.1080/02770903.2018.1553050 PMid:30915868

Tiotiu A, Ioan I, Wirth N, Romero-Fernandez R, González-Barcala FJ. The Impact of Tobacco Smoking on Adult Asthma Outcomes. Int J Environ Res Public Health [Internet]. 2021 Jan 23 [cited 2022 Jul 16];18(3):992. Doi: https://doi.org/10.3390/ijerph18030992 PMid:33498608 PMCid:PMC7908240

Price C, Agarwal G, Chan D, et al. Large care gaps in primary care management of asthma: a longitudinal practice audit. BMJ Open [In-ternet]. 2019 Jan 29 [cited 2022 Jul 15];9(1):e022506. Doi: https://doi.org/10.1136/bmjopen-2018-022506 PMid:30696669 PMCid:PMC6352804

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Published

2022-08-31

How to Cite

1.
Mukhopadhyay P, Chakraborty S, Sarkar M. Detection Of Treatment Adherence, Disease Control and Its Predictors in Asthma Patients by Rural Community Level Health Workers. Natl J Community Med [Internet]. 2022 Aug. 31 [cited 2024 Nov. 21];13(08):553-8. Available from: https://njcmindia.com/index.php/file/article/view/2101

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Original Research Articles