Effective asthma management strategies, especially regular use of inhaled corticosteroids, long-acting beta-agonists and asthma specialist care, are independently associated with better long-term asthma control. These findings are featured in the November 2006 Journal of Allergy & Clinical Immunology (JACI).
Previously, poor asthma control has been thought to be related to severe asthma, and proper asthma control was thought to be related to effective management, but concrete data to support these hypothesizes is limited.
In this study, “Determinants of future long-term asthma control,” Michael Schatz, MD, MS, FAAAAI, and colleagues sought to identify independent possible determinants of future long-term asthma control among asthma severity, management, demographic and comorbidity predictors. They surveyed a random sample of 2,250 health maintenance organization members aged 18 to 56 years with persistent asthma and tracking pharmacy data on medication dispensings.
The study found:
• A significant improvement in long-term control with increasing number of asthma management strategies, even after adjusting for the other predictors of long-term control.
• Long-term asthma control was significantly and inversely related to all severity-related asthma use measures tested.
• Long-term control was significantly and directly related to all management characteristics.
• Long-term control was significantly and inversely related to smoking and COPD but not to reflux.
• Poor long-term control was significantly related to younger age, lower educational level and being African American or male, but not income level.
Based on these findings, indicators of asthma severity and other patient characteristics are inversely related to future asthma control, but effective management strategies are associated with improved asthma control even after accounting for these high-risk characteristics.