Most patients do not follow/know the guidelines particularly what is adequate control and the severity is often underestimated. We tried to assess the adequacy of symptom control and the factors associated with inadequate control in Indian patients in reference to NIH guidelines.
A validated questionnaire was used. This included symptoms, treatment received, drugs prescribed, adequacy of control, Advice on avoidance of environmental exposure, home PEFR measurement. Adequacy of control was assessed by an index calculated from a total score, one point being given for each of the following: no exacerbation during last one month, sos medication, no audible wheeze, FEV1> 80%, PEFR variability < 20%, absence of dyspnoea on routine activity. Evaluation of factors associated with inadequate control of symptoms was assessed by severity of asthma, treatment recommendation as per NIH guidelines, drug dosage and duration, regularity of treatment and cause of irregularity.RESULT: 150 patients were included in the study (64 males and 86 females, age 13-73 years). 53 patients had mild intermittent, 46 had mild persistent, 48 had moderate, and 3 had severe persistent asthma. FEV1 was < 80% in 43. The mean score of adequacy of control was 0.59. Lack of control of asthma was due to several factors like noncompliance, treatment not as per NIH guidelines, lack of education, non-affordability, and side effects of medications. These were related to behavior of patients and physicians. Noncompliance was an ill-understood phenomenon. None was using a peak flow meter.
Asthma control was not satisfactory in many patients. Better education of patient and physician is required to have adequate control of asthma.CLINICAL IMPLICATION: Patient education and following of asthma guidelines is very important in asthma management.
R.K. Dalai, None.