J Korean Med Sci.  2015 Aug;30(8):1042-1047. 10.3346/jkms.2015.30.8.1042.

Predictors of Asthma Control by Stepwise Treatment in Elderly Asthmatic Patients

• Ban GY
• Ye YM
• Lee Y
• Kim JE
• Nam YH
• Lee SK
• Kim JH
• Jung KS
• Kim SH
• Park HS
• the Premier Researchers Aiming New Era in Asthma and Allergic Diseases (PRANA) Study Group

• KMID: 2164497
• DOI: http://doi.org/10.3346/jkms.2015.30.8.1042

Abstract

The geriatric population is increasing, and asthma severity increases with age. We determined the predictors of asthma control, exacerbation, and the factors that affect asthma-specific quality of life (A-QOL) in elderly asthmatic patients. This was a prospective, multicenter, real-life study for 6 months with stepwise pharmacologic treatment based on the Global Initiative for Asthma (GINA) guideline. A total of 296 asthmatic patients aged > or = 60 yr were recruited from 5 university centers in Korea. The improved-asthma control group was defined as the group of patients who maintained well-controlled or improved disease and the not-improved asthma control group was defined as the remaining patients. Fewer number of medications for comorbidities (2.8 +/- 3.3 in the improved vs. 4.5 +/- 4.4 in the control) and higher physical functioning (PF) scale (89.8 +/- 14.2 in the improved vs. 82.0 +/- 16.4 in the control) were significant predictors in the improved-asthma control group (OR = 0.863, P = 0.004 and OR = 1.028, P = 0.018, respectively). An asthma control test (ACT) score of < or = 19 at baseline was a significant predictor of asthma exacerbation (OR = 3.938, P = 0.048). Asthma duration (F = 5.656, P = 0.018), ACT score (F = 12.237, P = 0.001) at baseline, and the presence of asthma exacerbation (F = 5.565, P = 0.019) were significant determinants of changes in A-QOL. The number of medications for comorbidities and performance status determined by the PF scale may be important parameters for assessing asthma control in elderly asthmatic patients.

Keyword

Elderly; Asthma; Control; Performance; Comorbidity

MeSH Terms

Aged
Aged, 80 and over
Anti-Asthmatic Agents/*administration & dosage
Asthma/*diagnosis/epidemiology/*therapy
Critical Pathways/statistics & numerical data
Dose-Response Relationship, Drug
Female
Geriatric Assessment/*methods/statistics & numerical data
Humans
Male
Middle Aged
Outcome Assessment (Health Care)/*methods
*Quality of Life
Reproducibility of Results
Republic of Korea/epidemiology
Sensitivity and Specificity
Treatment Outcome
Anti-Asthmatic Agents

Figure

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  Fig. 1 Prevalence of comorbid conditions of study subjects. DM, diabetes mellitus; COPD, chronic obstructive pulmonary disease.

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