Evaluation of Asthma Control in the Dominican Republic: a Clinical Perspective
Article Sidebar
Main Article Content
Abstract
Introduction: Asthma is a respiratory pathology characterized by chronic and reversible airway inflammation. It is associated with modifiable and non-modifiable risk factors that influence its control and exacerbations. In countries such as Puerto Rico (22.8 %) and Cuba (23 %), the prevalence of asthma is significantly higher than the global prevalence (6.6 %).
Objective: To estimate the asthma status of adult asthmatic patients who attended the emergency or consultation of a center in the Dominican Republic based on absenteeism and the frequency of exacerbations of the pathology.
Methods: An observational cross-sectional study was conducted on patients diagnosed with asthma in a private clinic in the Dominican Republic. Data on asthma presentation and sociodemographic characteristics were collected. A sample size of 95 participants was used. Data was collected safely and analyzed using statistical methods: chi-square tests and logistic regression. Primary and secondary analyses were performed to evaluate asthma control and associated comorbidities.
Results: We obtained a sample of 92 participants of whom, in all control groups, reported having interrupted the purchase of medication due to its cost. Regarding work absenteeism, patients with total control lost 2 working days and patients with very poor control were absent for 9.96 days (p = 0.011). It was also found that patients with longer diagnosis time presented low asthma control (p=0.075).
Conclusion: This project highlights the importance of implementing a comprehensive approach to patients with asthma, in order to reduce the influence of factors that negatively affect the control of the pathology.
Downloads
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
Global Initiative for Asthma. Pocket Guide for Asthma Management and Prevention 2022. [Internet]. [Consultado 10 jun 2023]. Disponible en: https://ginasthma.org/wp-content/uploads/2022/07/GINA-2022-Pocket-Guide-WMS.pdf
Enilari O, Sinha S. The Global Impact of Asthma in Adult Populations. Ann Glob Health 2019;22;85(1). Doi: 10.5334/aogh.2412
Zhang T, Carleton BC, Prosser RJ, Smith AM. The added burden of comorbidity in patients with asthma. J Asthma 2009;46(10):1021–6. Doi: 10.3109/02770900903350473
To T, Stanojevic S, Moores G et al. Global asthma prevalence in adults: findings from the cross-sectional world health survey. BMC Public Health 2012;12:204. Doi: 10.1186/1471-2458-12-204
Drake KA, Galanter JM, Burchard EG. Race, ethnicity and social class and the complex etiologies of asthma. Pharmacogenomics 2008;9(4):453–62. Doi: 10.2217/14622416.9.4.453
Kabengele BO, Kayembe JMN, Kayembe PK, Kashongue ZM, Kaba DK, Akilimali PZ. Factors associated with uncontrolled asthma in adult asthmatics in Kinshasa, Democratic Republic of Congo. PLoS One 2019;14(4):e0215530. Doi: 10.1371/journal.pone.0215530
Markovitz BP, Andresen EM. Lack of insurance coverage and urgent care use for asthma: a retrospective cohort study. BMC Public Health 2006;6:14. Doi: 10.1186/1471-2458-6-14
Bafadhel M, Singapuri A, Terry S et al. Body mass and fat mass in refractory asthma: an observational 1 year follow-up study. J Allergy 2010:251758. Doi: 10.1155/2010/251758
Baptista-Serna L, Rodrigo-Muñoz JM, Mínguez P et al. Anxiety and body mass index affect asthma control: data from a prospective Spanish cohort. J Allergy Clin Immunol Pract 2022;10(3):863–6.e1. Doi: 10.1016/j.jaip.2021.10.013
Peters-Golden M, Swern A, Bird SS, Hustad CM, Grant E, Edelman JM. Influence of body mass index on the response to asthma controller agents. Eur Respir J 2006;27(3):495–503. Doi: 10.1183/09031936.06.00077205
Farah CS, Kermode JA, Downie SR et al. Obesity is a determinant of asthma control independent of inflammation and lung mechanics. Chest 2011;140(3):659–66. Doi: 10.1378/chest.11-0027
Clerisme-Beaty EM, Karam S, Rand C et al. Does higher body mass index contribute to worse asthma control in an urban population? J Allergy Clin Immunol 2009;124(2):207–12. Doi: 10.1016/j.jaci.2009.05.034
Dixon AE, Poynter ME. Mechanisms of Asthma in Obesity. Pleiotropic Aspects of Obesity Produce Distinct Asthma Phenotypes. Am J Respir Cell Mol Biol 2016;54(5):601–8. Doi: 10.1165/rcmb.2016-0017PS
Peters U, Dixon AE, Forno E. Obesity and asthma. J Allergy Clin Immunol 2018;141(4):1169–79. Doi: 10.1016/j.jaci.2018.02.004
Lange P, Parner J, Vestbo J, Schnohr P, Jensen G. A 15-year follow-up study of ventilatory function in adults with asthma. N Engl J Med 1998;339(17):1194–200. Doi: 10.1056/NEJM199810223391703
Porsbjerg C, Lange P, Ulrik CS. Lung function impairment increases with age of diagnosis in adult onset asthma. Respir Med 2015;109(7):821–7. Doi: 10.1016/j.rmed.2015.04.012
Stridsman C, Backman H, Hedman L, Rönmark E. Uncontrolled asthma on GINA step 4-5 treatment increases healthcare utilization – report from the population-based OLIN-studies. Eur Respir J 2019;54(suppl 63). DOI: 10.1183/13993003.congress-2019.PA1263
Seiger RS, Schatz M, Dalal AA et al. Utilization and Costs of Severe Uncontrolled Asthma in a Managed-Care Setting. J Allergy Clin Immunol 2016;4(1):120–9.e3.
Divo MJ, Martinez CH, Mannino DM. Ageing and the epidemiology of multimorbidity. Eur Respir J 2014;44(4):1055–68. Doi: 10.1183/09031936.00059814
Park HJ, Byun MK, Kim HJ 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. Doi: 10.1186/s13223-018-0250-0
Li P, To T, Guttmann A. Follow-up care after an emergency department visit for asthma and subsequent healthcare utilization in a universal-access healthcare system. J Pediatr 2012;161(2):208–13.e1. Doi: 10.1016/j.jpeds.2012.02.038
Wong A, Tavakoli H, Sadatsafavi M, Carlsten C, FitzGerald JM. Asthma control and productivity loss in those with work-related asthma: A population-based study. J Asthma 2017;54(5):537–42. Doi: 10.1080/02770903.2016.1220011
Ehteshami-Afshar S, FitzGerald JM, Carlsten C et al. The impact of comorbidities on productivity loss in asthma patients. Respir Res 2016;17(1):106. Doi: 10.1186/s12931-016-0421-9
Lee LK, Ramakrishnan K, Safioti G, Ariely R, Schatz M. Asthma control is associated with economic outcomes, work productivity and health-related quality of life in patients with asthma. BMJ Open Respir Res 2020;7(1). Doi: 10.1136/bmjresp-2019-000534
Al-Jahdali H, Anwar A, Al-Harbi A et al. Factors associated with patient visits to the emergency department for asthma therapy. BMC Pulm Med 2012;12:80. Doi: 10.1186/1471-2466-12-80
World Obesity Federation Global Obesity Observatory. Dominican Republic. [Internet]. [Consultado 10 jul 2023]. Disponible en: https://data.worldobesity.org/country/dominican-republic-58/
Mishra R, Kashif M, Venkatram S, George T, Luo K, Diaz-Fuentes G. Role of Adult Asthma Education in Improving Asthma Control and Reducing Emergency Room Utilization and Hospital Admissions in an Inner City Hospital. Can Respir J 2017;2017:5681962. Doi: 10.1155/2017/5681962