Risk factors hindering asthma symptoms control in Saudi children and adolescents. Pediatrics International
Journal Article
, Halwani, R., Vazquez-Tello, A., Horanieh, N., Dulgom, S., Al-Aseri, Z., Al-Khamis, N., Al-Sum, Z., Al-Jahdali, H. and Al-Muhsen, S. (2017), . 2017
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original article
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Keywords:
- Pediatric asthma;
- asthma control test;
- risk factors;
- Saudi Arabia;
- medication compliance;
- inhaler device;
- MDI ;
- DPI
Abstract
Background
Maintaining well control of asthma symptoms can help preventing exacerbations and its associated complications. The Asthma Control Test (ACT) can rapidly assess the effectiveness of asthma management plan and therapy.
Objective
To identify risk factors associated with uncontrolled asthma symptoms in young Saudi asthmatics (3-17 years-old).
Methods
In this cross-sectional hospital-based survey, the ACT was administered to 297 asthmatic children/adolescents, recruited at the emergency department (ED) of two major hospitals.
Results
Most recruited patients were intermittent (63.5%) and mild-persistent (27.6%) asthmatics; few were moderate-persistent (8.9%) and none were severe asthmatics. These patients visited the ED 4 times (3.9±3.2), on average. Almost half of patients declared not receiving education about asthma (47%) nor education about medication use (43%). Most patients (60.3%) had uncontrolled symptoms (ACT score ≤19), of which intermittent asthmatics presented better scores than patients with more severe symptoms. Children ≤6 years-old, with symptoms diagnosed <5 years ago and who were not attending school, had significantly worse control than older patients. Poor medication compliance and inappropriate inhaler device use were ascribed to younger patients (<12 years-old) and worse scores; particularly in relation to the practice to stop inhaled corticosteroid (ICS) therapy when their symptoms improve. Patients with poor control declared also not having received education about inhaler device use.
Conclusions
Most Saudi asthmatic children/adolescents visiting the ED had poor control of symptoms; indeed, none achieved complete control, which is related to deficient medication compliance and improper medication inhaler device use; deficient knowledge about asthma was also another factor hindering control.