Abstract
Background and objectives: Asthma is a chronic disease with major public health and financial consequences. One of basic approaches in managing asthmatic patients is monitoring to maintain control and identifying cases of exacerbations. Poor adherence to treatment, poor baseline control of disease, frequent hospital admission and emergency department visits are among factors associated with poor outcome of asthma. Of parameters leading to disease exacerbation are Co-morbidities such as sinusitis as well, genetic and familial predisposition for asthma. This study was designed to follow patients regarding to achieving control, identify disease exacerbations and discover relation between exacerbation with poor treatment adherence, co-morbidities and history of atopy in patient or family.
Materials and methods: In a cross sectional-analytic study, 400 asthmatic patients in the range of 2-14 years old who were visited at the specialized outpatient clinic of Tabriz University of Medical Sciences were divided and studied on the base of disease severity .At the end (at least one year treatment), patients were categorized based on level of disease control and one year after this stage, cases of exacerbation were identified and studied.
Results: By excluding patients with poor adherence, 342 patients continued treatment as intermittent, mild persistent, moderate persistent and severe persistent asthma (38,235,61and8patients respectively). After a period of one year treatment, the patients were divided as well controlled, partially controlled and uncontrolled (68%, 30%and 2% respectively) .Cases of disease exacerbations were more if sinusitis, familial asthma history and poor adherence were present(p<0.01, p<0.01 and p<0.05 respectively). There was no significant relation between asthma exacerbation and history of allergy in patient or family (p=0.2) Conclusion: There is meaningful association between pooradherence, sinusitis and positive family history of asthma with disease exacerbations.