Asthma Treatment Outcome and Factors Associated with Uncontrolled Asthma among Adult Asthmatic Patients Attending Ambulatory Care Units of Selected Public Hospitals in Addis Ababa, Ethiopia: A Cross-Sectional Study

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Addis Ababa University


Background: Asthma is a major health challenge globally where majority of the patients have uncontrolled disease status. To this effect, development of various management protocols and considerable effort have been develop in broad understanding of important behavioral, social and administrative aspects of asthma care. However, lists of socio-demographic factors, disease characteristics factors and medication related conditions were revealed as risk factors for uncontrolled asthma. Objective: To assess asthma treatment outcome and factors associated with uncontrolled asthma among adult asthmatic patients attending ambulatory care units of selected public hospitals in Addis Ababa, Ethiopia. Methods: A cross-sectional study was conducted in selected public hospitals of Addis Ababa (Saint. Paul's Hospital Millennium Medical College and Menelik II Referral Hospitals) between March 1 to June 30, 2018. A consecutive sampling technique was employed to enroll asthmatic patients taking anti-asthmatic medications for at least three months. Pretested interviewer administrated questionnaire adopted from Global Initiative for Asthma Guideline, Medication Adherence Rating Scale and Beliefs about Medicine Questionnaire tools were used to collect the required data through chart review and patient interview. Asthma treatment outcome was categorized as controlled, partially controlled and uncontrolled. Descriptions of variables were done using frequencies and proportion while multivariate logistic regression analysis was employed to identify factors associated with uncontrolled asthma. The strength of association was presented by odds ratio with 95% CI and variable with p < 0.05 were considered as statistically significant. Data were entered and analyzed using SPSS version 20.0. Results: A total of 230 (response rate of 98.2%) study participants were interviewed. More than half (65.2%) of respondents were females and their mean age was 54±15.1 years. About 116 (50.4%) patients had uncontrolled asthma status. Moderate persistent (40%) and mild intermittent (21.7%) asthma was ascribed by high proportion of asthma severity. Patients on salbutamol puff as needed + beclomethasone puff BID (43.5%) followed by salbutamol puff as needed + beclomethasone puff BID + prednisolone (23.9%). Cold weather [AOR=2.16; 95%CI:1.00-4.63], exacerbations of asthma in the last 12 months [AOR=2.37; 95%CI:1.26-4.45], moderate persistent [AOR=3.62;95%CI:1.50-8.69], severe persistent [AOR=2.90;95%CI:1.03-8.20], patients on salbutamol puff with beclomethasone [AOR=5.95;95%CI:2.00-17.72] and patients on salbutamol puff with beclomethasone and prednisolone [AOR=15.50;95%CI:4.62-52.36] were found to be significantly associated with uncontrolled asthma. Adherence rate to controller anti-asthmatic medications was found to be 79 (44.9%). Conclusion: The study showed that more than half of asthmatic patients had uncontrolled asthma status and the rate of non-adherence towards controller medication was high, which warrants that health care providers should focus on medication adherence and strengthening asthma care education program.



Asthma, treatment outcome, uncontrolled asthma, adherence, severity, exacerbations and trigger factors.