TY - JOUR
T1 - Asthma control and care among six public health clinic attenders in Malaysia
T2 - A cross-sectional study
AU - RESPIRE collaborators
AU - Hussein, Norita
AU - Liew, Su May
AU - Hanafi, Nik Sherina
AU - Lee, Ping Yein
AU - Cheong, Ai Theng
AU - Shariff-Ghazali, Sazlina
AU - Chinna, Karuthan
AU - Pang, Yong-Kek
AU - Kassim, Asiah
AU - Parker, Richard A
AU - Schwarze, Jürgen
AU - Sheikh, Aziz
AU - Pinnock, Hilary
AU - Khoo, Ee Ming
N1 - Funding Information:
The RESPIRE collaboration comprises the UK Grant holders, Partners and research teams as listed on the RESPIRE website ( www.ed.ac.uk/usher/respire ), including Rizawati Ramli, Azainorsuzila Mohd Ahad, Ahmad Ihsan Abu Bakar, Bee Kiau Ho, Salbiah Mohamad Isa, Harzana Harun, Izan Ishak, Zuzana Aman, Asnita Nordin, Siow Foon Tan, Chiu Wan Ng, and Harish Nair. We would like to thank five representatives from the Patient and Public involvement (PPI) group for their contribution in the development of the study protocol, questionnaires, participant information sheets and consent form including the conduct of recruiting patients. We gratefully acknowledge Jaiyogesh Patel for his help with data collection, analysis and assisting in preparing the manuscript. The authors would like to thank the Director General of Health Malaysia for the permission to publish this paper. This study is funded by National Institute for Health Research (NIHR) Global Health Research Unit on Respiratory Health (RESPIRE).
Publisher Copyright:
© 2023 The Authors. Health Science Reports published by Wiley Periodicals LLC.
PY - 2023/5/2
Y1 - 2023/5/2
N2 - BACKGROUND AND AIMS: Asthma is common in Malaysia but neglected. Achieving optimal asthma control and care is a challenge in the primary care setting. In this study, we aimed to identify the risk factors for poor asthma control and pattern of care among adults and children (5-17 years old) with asthma attending six public health clinics in Klang District, Malaysia.METHODS: We conducted a cross-sectional study collecting patients' sociodemographic characteristics, asthma control, trigger factors, healthcare use, asthma treatment, and monitoring and use of asthma action plan. Descriptive statistics and stepwise logistic regression were used in data analysis.RESULTS: A total of 1280 patients were recruited; 85.3% adults and 14.7% children aged 5-17 years old. Only 34.1% of adults had well-controlled asthma, 36.5% had partly controlled asthma, and 29.4% had uncontrolled asthma. In children, 54.3% had well-controlled asthma, 31.9% had partly controlled, and 13.8% had uncontrolled asthma. More than half had experienced one or more exacerbations in the last 1 year, with a mean of six exacerbations in adults and three in children. Main triggers for poor control in adults were haze (odds ratio [OR] 1.51; 95% confidence interval [CI] 1.13-2.01); cold food (OR 1.54; 95% CI 1.15-2.07), extreme emotion (OR 1.90; 95% CI 1.26-2.89); air-conditioning (OR 1.63; 95% CI 1.20-2.22); and physical activity (OR 2.85; 95% CI 2.13-3.82). In children, hot weather (OR 3.14; 95% CI 1.22-8.11), and allergic rhinitis (OR 2.57; 95% CI 1.13-5.82) contributed to poor control. The majority (81.7% of adults and 64.4% of children) were prescribed controller medications, but only 42.4% and 29.8% of the respective groups were compliant with the treatment. The importance of an asthma action plan was reported less emphasized in asthma education.CONCLUSION: Asthma control remains suboptimal. Several triggers, compliance to controller medications, and asthma action plan use require attention during asthma reviews for better asthma outcomes.
AB - BACKGROUND AND AIMS: Asthma is common in Malaysia but neglected. Achieving optimal asthma control and care is a challenge in the primary care setting. In this study, we aimed to identify the risk factors for poor asthma control and pattern of care among adults and children (5-17 years old) with asthma attending six public health clinics in Klang District, Malaysia.METHODS: We conducted a cross-sectional study collecting patients' sociodemographic characteristics, asthma control, trigger factors, healthcare use, asthma treatment, and monitoring and use of asthma action plan. Descriptive statistics and stepwise logistic regression were used in data analysis.RESULTS: A total of 1280 patients were recruited; 85.3% adults and 14.7% children aged 5-17 years old. Only 34.1% of adults had well-controlled asthma, 36.5% had partly controlled asthma, and 29.4% had uncontrolled asthma. In children, 54.3% had well-controlled asthma, 31.9% had partly controlled, and 13.8% had uncontrolled asthma. More than half had experienced one or more exacerbations in the last 1 year, with a mean of six exacerbations in adults and three in children. Main triggers for poor control in adults were haze (odds ratio [OR] 1.51; 95% confidence interval [CI] 1.13-2.01); cold food (OR 1.54; 95% CI 1.15-2.07), extreme emotion (OR 1.90; 95% CI 1.26-2.89); air-conditioning (OR 1.63; 95% CI 1.20-2.22); and physical activity (OR 2.85; 95% CI 2.13-3.82). In children, hot weather (OR 3.14; 95% CI 1.22-8.11), and allergic rhinitis (OR 2.57; 95% CI 1.13-5.82) contributed to poor control. The majority (81.7% of adults and 64.4% of children) were prescribed controller medications, but only 42.4% and 29.8% of the respective groups were compliant with the treatment. The importance of an asthma action plan was reported less emphasized in asthma education.CONCLUSION: Asthma control remains suboptimal. Several triggers, compliance to controller medications, and asthma action plan use require attention during asthma reviews for better asthma outcomes.
KW - asthma
KW - asthma control
KW - primary care
KW - risk factors
U2 - 10.1002/hsr2.1021
DO - 10.1002/hsr2.1021
M3 - Article
C2 - 37152232
SN - 2398-8835
VL - 6
SP - e1021
JO - Health Science Reports
JF - Health Science Reports
IS - 5
M1 - e1021
ER -