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Allergy and Airway |

Factors Associated With Poor Asthma Control in the Behavioral Risk Factor Surveillance System (BRFSS) Asthma Call-Back Survey 2009

Joseph Espiritu, MD
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Saint Louis University, St. Louis, MO


Chest. 2013;144(4_MeetingAbstracts):72A. doi:10.1378/chest.1676636
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Abstract

SESSION TITLE: Asthma Diagnosis & Evaluation

SESSION TYPE: Original Investigation Slide

PRESENTED ON: Tuesday, October 29, 2013 at 02:45 PM - 04:15 PM

PURPOSE: To determine the predictors of poor asthma control and the proportion of poorly-controlled asthmatics receiving controller medications using the Behavioral Risk Factor Surveillance System (BRFSS) Asthma Call-Back Survey (ACBS) 2009.

METHODS: The BRFSS-ACBS 2009 for adults was analyzed to determine whether poor asthma control (symptoms, exacerbation, emergency department (ED)/urgent care visits) was associated with demographics, asthma management education, immunization, and inhaled corticosteroid use.

RESULTS: One-third of asthmatics had poor asthma control. Thirty-eight percent had an exacerbation while 9% had visited an ED/urgent care center for uncontrolled symptoms in the past 12 months. Women were 1.794 (95%CI=1.665-1.933) times more likely than men to have an asthma attack and 1.854 (95%CI=1.616-2.126) times more likely to visit an ED/urgent care center during the past year. Patients who were ever taught to recognize early signs or symptoms of asthma were more likely to have good symptom control [p=.016], less likely to have suffered an asthma attack during the past 12 months [p<.001], and less likely to have had an ED/urgent care visit during the past year [p<.001]. Influenza vaccination during the past year was significantly associated with a reduction in asthma attacks [p=.005] and ED/urgent care visits during the past year [p=.001]. Pneumococcal vaccination was associated with significant improvement in symptom control [p=.042], asthma attacks [p<.001] and ED/urgent care visits [p<.001] in the past year. Of the 150 asthmatics with poor symptom control, only half of them used an inhaled corticosteroid medication. Inhaled corticosteroid use appeared to be associated with a significantly lower number of ED /urgent care visits during the past year [p<.0001].

CONCLUSIONS: Although more than a third of asthmatics suffered from poor symptom control and exacerbations and almost a tenth required emergency or urgent care visit/s during the past 12 months, only half of poorly controlled asthmatics were on inhaled corticosteroids.

CLINICAL IMPLICATIONS: Intensification of guideline-based of patients and their health care providers may reduce prevalence of poor asthma control and incidence of ED/urgent care visits.

DISCLOSURE: The following authors have nothing to disclose: Joseph Espiritu

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