Methods for asthma management are independently associated with better long-term control, from the Journal of Allergy and Clinical Immunology

MILWAUKEE - Effective asthma management strategies, especially regular use of inhaled corticosteroids, long-acting beta-agonists and asthma specialist care, are independently associated with better long-term asthma control. These findings are featured in the November 2006 Journal of Allergy & Clinical Immunology (JACI).

Previously, poor asthma control has been thought to be related to severe asthma, and proper asthma control was thought to be related to effective management, but concrete data to support these hypothesizes is limited.

In this study, "Determinants of future long-term asthma control," Michael Schatz, MD, MS, FAAAAI, and colleagues sought to identify independent possible determinants of future long-term asthma control among asthma severity, management, demographic and comorbidity predictors. They surveyed a random sample of 2,250 health maintenance organization members aged 18 to 56 years with persistent asthma and tracking pharmacy data on medication dispensings.

Predictors for poor long-term control in this study included more than two dispensings of oral corticosteroids in the prior year, a history of any asthma hospitalizations, any unscheduled visits for asthma in the past year, smoking, chronic obstructive pulmonary disease (COPD), lower educational level and being African American or male. Predictors for better long-term asthma control were regular specialist care and regular use of inhaled corticosteroids and long-acting beta-agonists.

The study found:

• A significant improvement in long-term control with increasing number of asthma management strategies, even after adjusting for the other predictors of long-term control.
• Long-term asthma control was significantly and inversely related to all severity-related asthma use measures tested.
• Long-term control was significantly and directly related to all management characteristics.
• Long-term control was significantly and inversely related to smoking and COPD but not to reflux.
• Poor long-term control was significantly related to younger age, lower educational level and being African American or male, but not income level.

Based on these findings, indicators of asthma severity and other patient characteristics are inversely related to future asthma control, but effective management strategies are associated with improved asthma control even after accounting for these high-risk characteristics.

About the AAAAI

The AAAAI represents allergists, asthma specialists, clinical immunologists, allied health professionals and others with a special interest in the research and treatment of allergic disease. Established in 1943, the AAAAI has more than 6,500 members in the United States, Canada and 60 other countries. The AAAAI serves as an advocate to the public by providing educational information and a physician referral directory through its Web site at www.aaaai.org.

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