ABSTRACT

Introduction: In the world, adequate asthma control has not been achieved; this being one of the main objectives of the treatment. Objectives: Describe asthma control, clinical and epidemiological characteristics in Panama. Material and methods: Observational study through the application of a survey in the outpatient consultation room of the pulmonology department in a 3rd level hospital from January to March 2019. Results: 97 patients, average age: 57 years (SD 12.9), female 77%. Asthma control: uncontrolled 52%, partially controlled 40%, fully controlled 8%. Bad adherence to inhalers 54%. Bad inhalation technique 25%. They referred one or more urgent visits for asthma last year: 51%, hospitalizations 7%. Comorbidities associated with poor asthma control: former smoker 16%, active smoker 1%, obesity 51%, allergic rhinitis 35%, gastroesophageal reflux 38%, depression 2%. Frequency of household factors associated with poor asthma control: 72% dust, 61% disinfectants, 55% aerosols, 48% pets. We only found a significant difference for uncontrolled asthma in the presence of allergic rhinitis, poor inhalation technique and greater use of healthcare resources. Conclusion: Asthma control was similar to reports in Latin America, keeping poorly controlled at more than 50%.

KEYWORDS

Asthma control, asthma control test, Latin American population, therapeutic adherence.

REFERENCES

1. Organización Mundial de la Salud. Enfermedades respiratorias crónicas: Asma. 2018. Fecha de consulta: 9 de mayo, 2018. Disponible en: http://www.who.int/respiratory/asthma/es/.

2. Solé D, Sanchez AC, Falbo WG. Asthma: epidemiology of disease control in Latin America-short review. Asthma Res Pract. 2017;3:4. https://doi.org/10.1186/s40733-017-0032-3

3. Valverde Z, Ruiloba A. Ministerio de Salud de Panamá. Base de datos pública. 2014. Disponible en: http://www.minsa.gob.pa/sites/default/files/publicacion-general/ind._basicos_pma_2014.pdf

4. Martínez EM. Control del asma: un objetivo lejano. Arch Bronconeumol. 2010;46:347-348. https://doi.org/10.1016/j.arbres.2010.03.009

5. NICE Guidelines. Asthma: diagnosis, monitoring and chronic asthma management. Published date: November 2017. Available from: https://www.nice.org.uk/guidance/ng80

6. Global Strategy for Asthma. Global Strategy for Asthma Management and Prevention. Uptodate 2017. Available from: www.ginasthma.org

7. Gold LS, Montealegre F, Allen-Ramey FC, Jarmin J, Sansores R, Sullivan SD. Asthma control and cost in Latin America. Value Health Reg Issues. 2014;5:25-28. https://doi.org/10.1016/j.vhri.2014.06.007

8. Zafari Z, Sadatsafavi M, Chen W, FitzGerald JM. The projected economic and health burden of sub-optimal asthma control in Canada. Respir Med. 2018;138:7-12. www.doi.org/10.1016/j.rmed.2018.03.018

9. Guía Española para el Manejo del Asma. Versión 4.2, 2017. Disponible en: www.gemasma.com

10. Gemicioglu B, Bayram H, Cimrin A, Abadoglu O, Cilli A, Uzaslan E, et al. Asthma control and adherence in newly diagnosed young and elderly adult patients with asthma in Turkey. J Asthma. 2018;56(5): 553-561. https://doi.org/10.1080/02770903.2018.1471707

11. Calvo E, Trigueros JA, López A, Sánchez G. Control del asma en pacientes que acuden a consulta de atención primaria en España (estudio ACTIS). Aten Primaria. 2017;49(10):586-592. https://doi.org/10.1016/j.aprim.2016.12.005

12. Athanazio R, Carvalho-Pinto R, Fernandes FL, Rached S, Rabe K, Cukier A, et al. Can severe asthmatic patients achieve asthma control? A systematic approach in patients with difficult to control asthma followed in a specialized clinic. BMC Pulm Med. 2016;16(1):153. www.doi.org/10.1186/s12890-016-0314-1

13. Alvear GT, Figueroa LR, Hurtado JG, Moyano LM. Evaluación del grado de control del asma en un centro de atención primaria. Un estudio descriptivo. Rev Chil Enferm Respir. 2016;32(2):68-76. http://dx.doi.org/10.4067/S0717-73482016000200002.

14. Neffen H, Fritscher C, Schacht CF, Levy G, Chiarella P, Soriano JB, et al.; AIRLA Survey Group. Asthma control in Latin America: the Asthma Insights and Reality in Latin America (AIRLA) survey. Rev Panam Salud Publica. 2005;17(3):191-197. https://doi.org/10.1590/s1020-49892005000300007

15. Nathan RA, Sorkness CA, Kosinski M, Schatz M, Li JT, Marcus P, et al. Development of the asthma control test: a survey for assessing asthma control. J Allergy Clin Immunol. 2004;113(1):59-65. www.doi.org/10.1016/j.jaci.2003.09.008

16. Plaza V, López-Viña A, Cosio BG. El test de adhesión a los inhaladores. Arch Bronconeumol. 2017;53(7):360-361. www.doi.org/10.1016/j.arbres.2016.08.006

17. Ruiz CMA. Resultados estudio ESCASE. Estudio control del asma en España. Rev Patol Respir. 2006;9(Supl 1):29-30.

18. González-Barcala FJ, de la Fuente-Cid R, Álvarez-Gil R, Tafalla M, Nuevo J, Caamaño-Isorna F. Factores asociados con el control del asma en pacientes de atención primaria en España: el estudio CHAS. Arch bronconeumol. 2010; 46(7):358-363. www.doi.org/10.1016/j.arbres.2010.01.007

19. Nathan RA, Thompson PJ, Price D, Fabbri LM, Salvi S, González-Díaz S, et al. Taking aim at asthma around the world: Global results of the asthma insight and management survey in the Asia-Pacific Region, Latin America, Europe, Canada, and the United States. J Allergy Clin Immunol Pract. 2015;3(5):734-742.e5. www.doi.org/10.1016/j.jaip.2015.04.013.

20. Tarraf H, Al-Jahdali H, AI Qaseer AH, Gjurovic A, Haouichat H, Khassawneh B, et al. Asthma control in adults in the Middle East and North Africa: Results from the ESMAA study. Respir Med. 2018;138:64-73. https://doi.org/10.1016/j.rmed.2018.03.024

21. Al-Sheyab NA, Alomari MA. Prevalence, associated factors, and control level of asthma symptoms among adolescents in Northern Jordan. Int J Adolesc Med Health. 2018;32(3):/j/ijamh.2020.32.issue-3/ijamh-2017-0159/ijamh-2017-0159.xml. www.doi.org/10.1515/ijamh-2017-0159

22. Ross ND, Taylor DMcD, Sellar AJ, Chen HH, Plant LD, McLean D, et al. Community asthma management of emergency department patients: A pilot study of adherence with national consensus guidelines. Emerg Med Australas. 2018; 30(3): 423-425. https://doi.org/10.1111/1742-6723.13092

23. Melero MC, Rodríguez MN, Díaz CR. Adherencia al tratamiento en asma. Situación actual. Rev Asma. 2017;2(1):13-22.

24. Gagné M, Boulet LP, Pérez N, Moisan J. Patient-reported outcome instruments that evaluate adherence behaviours in adults with asthma: a systematic review of measurement properties. Br J Clin Pharmacol. 2018;84(9):1928-1940. www.doi.org/10.1111/bcp.13623