A cross sectional study of patients with poorly controlled asthma at a referral centre


  • Shobitha Rao Department of Respiratory Medicine, Srinivas Institute of Medical Sciences and Referral Centre, Mukka, Mangalore, India




Asthma, Allergens, Comorbidity, Poorly controlled


Background: Asthma is a common chronic disease of the airways. Poorly controlled asthma has significant impact on social and economic factors. This study was done to analyse the clinical profile of patients with poorly controlled asthma.

Methods: This is an observational, cross sectional study. Total of 100 patients were evaluated. Data collected included symptomatology, assessment of asthma control by asthma control test scoring, spirometry, body mass index, co-morbidities and allergy testing report.

Results: Among the 100 patients studied, 52% (n=52) were in the age group of 30 to 60 years. 48% (n=48) were males and 52% (n=52) were females. 76% (n=76) patients had adhered to treatment for bronchial asthma as advised which was in line with standard therapy. 86% (n=86) had co-existing illness. They included allergic rhinitis, obesity, GERD, anxiety, atopic dermatitis and chronic urticaria. 78% (n=78) of these cases were sensitized to indoor and outdoor allergens. 89% of sensitized cases were to house dust mite (n=70 of 78). This was followed by cockroach sensitization which was seen in 30.7% cases (n=24 of 78). Other allergens included pollens in 28.2% cases (n=22 of 78), aspergillus in 25.6% cases (n=20 of 78) and food allergens in 23% cases (n=18 of 78).

Conclusions: Poorly controlled asthma cases require detailed evaluation of comorbid conditions and allergen sensitization profiles. Management of these conditions along with allergen control measures may benefit these patients along with step up of therapy.


Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention, 2018. Available at www.ginasthma.org.

Global Asthma Network. The Global Asthma Report, 2018. Available at http://globalasthmareport.org.

Koul PA, Patel D. Indian guidelines for asthma: Adherence is the key. Lung India off Organ Indian Chest Soc. 2015;32(1):S1.

Braido F. Failure in asthma control: reasons and consequences. Sci. 2013.

Koshak EA. Classification of asthma according to revised, 2006. GINA: evolution from severity to control. Ann Thoracic Med. 2007;2(2):45.

Reddel HK, Bateman ED, Becker A, Boulet LP, Cruz AA, Drazen JM, et al. A summary of the new GINA strategy: a roadmap to asthma control. Euro Resp J. 2015;46(3):622-39.

LeBlanc A, Robichaud P, Lacasse Y, Boulet LP. Quantification of asthma control: validation of the Asthma Control Scoring System. Allergy. 2007;62(2):120-5.

Juniper EF, Svensson K, Mörk AC, Ståhl E. Measurement properties and interpretation of three shortened versions of the asthma control questionnaire. Resp Med. 2005;99(5):553-8.

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.

Skinner EA, Diette GB, Algatt-Bergstrom PJ, Nguyen TT, Clark RD, Markson LE, et al. The asthma therapy assessment questionnaire (ATAQ) for children and adolescents. Dis Man. 2004;7(4):305-13.

Magnoni MS, Latorre M, Bettoncelli G, Sanchez-Herrero MG, Lopez A, Calvo E, et al. Asthma control in primary care: the results of an observational cross-sectional study in Italy and Spain. World Allergy Org J. 2017;10(1):13.

Chapman S, Dale P, Svedsater H, Stynes G, Vyas N, Price D, et al. Adherence to asthma medication and preferences for once-daily treatment: Importance of treatment intrusiveness and patient beliefs. Euro Resp J. 2016;48(60):PA5018.

Souza-Machado A, Santos PM, Cruz ÁA. Adherence to treatment in severe asthma: predicting factors in a program for asthma control in Brazil. World Allergy Org J. 2010;3(3):48.

Demoly P, Annunziata K, Gubba E, Adamek L. Repeated cross-sectional survey of patient reported asthma control in Europe in the past 5 years. Eur Respir Rev. 2012;21(123):66–74.

Stevens M, Stokes J, Walters R, Schatz M, Casale T. Rates of comorbidities are related to level of asthma control. J Allergy Clin Immunol. 2014;133(2).

Hwang EK, Jin HJ, Nam YH, Shin YS, Ye YM, Nahm DH, et al. The predictors of poorly controlled asthma in elderly. Allergy Asthma Immunol Res. 2012;4(5):270-6.

Ghanname I, Chaker A, Hassani AC, Herrak L, Ebongue SA, Laine M, et al. Factors associated with asthma control: MOSAR study (Multicenter Observational Study of Asthma in Rabat-Morocco). BMC Pulmonary Med. 2018;18(1):61.

Tanaka A, Fujiwara A, Uchida Y, Yamaguchi M, Ohta S, Homma T, et al. Evaluation of the association between sensitization to common inhalant fungi and poor asthma control. Ann Allergy Asthma Immunol. 2016;117(2):163-8.

Burbank AJ, Grabich SC, Todorich K, Frye M, Loughlin C, et al. Effect of aeroallergen sensitization on asthma control in African American teens with persistent asthma. Ann Allergy Asthma Immunol. 2016;117(4):442-4.

Rhee H, Love T, Harrington D, Grape A. Common allergies in urban adolescents and their relationships with asthma control and healthcare utilization. Allergy Asthma Clin Immunol. 2018;14(1):33.

Zillmer LR, Gazzotti MR, Nascimento OA, Montealegre F, Fish J, Jardim JR. Gender differences in the perception of asthma and respiratory symptoms in a population sample of asthma patients in four Brazilian cities. J Bras Pneumol. 2014;40(6):591-8.

Day A, Ernst P, Glick L, Zimmerman S, Chapman KR. Women and asthma: lessons from a gender analysis of the asthma in Canada survey. J Asthma. 2006;43(2):169-73.

Singh AK, Jain VK, Mishra M. Clinical profile of bronchial asthma patients reporting at respiratory medicine outpatient department of teaching hospital. Ind J Allergy Asthma Immunol. 2015;29(1):3.

Fuseini H, Newcomb DC. Mechanisms driving gender differences in asthma. Current Allergy Asthma Rep. 2017;17(3):19.






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