Predictors of Asthma Control by Stepwise Treatment in Elderly Asthmatic Patients

J Korean Med Sci. 2015 Aug;30(8):1042-7. doi: 10.3346/jkms.2015.30.8.1042. Epub 2015 Jul 15.

Abstract

The geriatric population is increasing, and asthma severity increases with age. We determined the predictors of asthma control, exacerbation, and the factors that affect asthma-specific quality of life (A-QOL) in elderly asthmatic patients. This was a prospective, multicenter, real-life study for 6 months with stepwise pharmacologic treatment based on the Global Initiative for Asthma (GINA) guideline. A total of 296 asthmatic patients aged ≥ 60 yr were recruited from 5 university centers in Korea. The improved-asthma control group was defined as the group of patients who maintained well-controlled or improved disease and the not-improved asthma control group was defined as the remaining patients. Fewer number of medications for comorbidities (2.8 ± 3.3 in the improved vs. 4.5 ± 4.4 in the control) and higher physical functioning (PF) scale (89.8 ± 14.2 in the improved vs. 82.0 ± 16.4 in the control) were significant predictors in the improved-asthma control group (OR = 0.863, P = 0.004 and OR = 1.028, P = 0.018, respectively). An asthma control test (ACT) score of ≤ 19 at baseline was a significant predictor of asthma exacerbation (OR = 3.938, P = 0.048). Asthma duration (F = 5.656, P = 0.018), ACT score (F = 12.237, P = 0.001) at baseline, and the presence of asthma exacerbation (F = 5.565, P = 0.019) were significant determinants of changes in A-QOL. The number of medications for comorbidities and performance status determined by the PF scale may be important parameters for assessing asthma control in elderly asthmatic patients.

Keywords: Asthma; Comorbidity; Control; Elderly; Performance.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anti-Asthmatic Agents / administration & dosage*
  • Asthma / diagnosis*
  • Asthma / epidemiology
  • Asthma / therapy*
  • Critical Pathways / statistics & numerical data
  • Dose-Response Relationship, Drug
  • Female
  • Geriatric Assessment / methods*
  • Geriatric Assessment / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care / methods*
  • Quality of Life*
  • Reproducibility of Results
  • Republic of Korea / epidemiology
  • Sensitivity and Specificity
  • Treatment Outcome

Substances

  • Anti-Asthmatic Agents