Level of Asthma Control and Associated Factors among Asthmatic Adult patients who AttendedSaint Paul’s hospital millennium medical college (SPHMMC) Chest Clinic of Addis Ababa, Ethiopia, 2023.

Abstract

Abstract Background: The goal of asthma treatment is to obtain and maintain a good control of symptoms. Investigating factors associated with uncontrolled asthma could help in strategies to improve asthma control. There are a few studies in this field that examine the level of asthma control using validated questionnaires like the Asthma Control Test. Objective: to determine the prevalence and factors associated with asthma control in asthma patients under St. Paul hospital millennium medical college chest clinic Addis Ababa Ethiopia. Methods: A cross-sectional study was conducted from March 2023 to May 2023. Systematic random sampling technique was used to take a total of 284 asthma patients. Physician-diagnosed asthma patients aged 18 years and above were included. A structured questionnaire was used to collect demographic data, comorbidities, and medical history of asthma. Asthma control was assessed using the standardized and validated Asthma Control Test, with a score cut points of less than 20 for uncontrolled asthma and a score greater or equal to 20 for well controlled asthma. A multivariate analysis was used to identify factors associated with uncontrolled asthma. Results: Overall, 281 patients were included in this study with 98.94% response rate. Asthma was controlled in 80(28.5%) patients and uncontrolled in 201 (71.5%). The mean duration of asthma was 22±14.8years. One hundred sixty (56.9%) patients were under controller medication while the mean ACT score was 16 .81 ±3 .43. Independent associations were found between uncontrolled asthma andseparated/divorced/widowed (AOR 6.62695% CI.1.251 – 35.084, p = 0.026),comorbidity (AOR 6.208, 95% CI 2.149-17.937, p<0.001), irregular chest clinic follow up (AOR 9.918, 95% CI 3.575 27.512, p<.001),inappropriate MDI technique (AOR 3.546, 95% CI 1.393-9.028.p< .001), and taking SABA + ICS and ICS + LABA asthma medication (AOR .017, 95%CI .003-.087, p<.001,AOR .047, 95%CI .011-.201,p<.001) was less likely to develop uncontrolled asthma when compared to patient who took SABA only. Conclusion: Asthma remains poorly controlled in a large proportion of asthma patients under SPHMMC chest clinic. Educational programs for asthma patients targeting comorbidity management, regular follow up and appropriate Metered dose inhalation technique may help in improving the control of asthma. Key words: asthma control, chest clinic, Asthma control test, Metered dose inhalation