Li Xiang1, Jing Zhao2, Yuejie Zheng3, Hanmin Liu4, Jianguo Hong5, Yixiao Bao6, Aihuan Chen7, Li Deng8, Wei Ji9, Nanshan Zhong10, Kunling Shen1. 1. a Department of Respiratory Disease , Beijing Children's Hospital, Capital Medical University , Beijing , China. 2. b Department of Respiratory Disease , Children's Hospital Affiliated with Capital Institute of Pediatrics , Beijing , China. 3. c Department of Respiratory Disease , Shenzhen Children's Hospital , Shenzhen , China. 4. d Department of Respiratory Disease , West China Second University Hospital , Chengdu , China. 5. e Department of Pediatrics , Shanghai General Hospital , Shanghai , China. 6. f Department of Pediatrics Respiratory Disease , Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine , Shanghai , China. 7. g Department of Respiratory Disease , The First Affiliated Hospital of Guangzhou Medical University , Guangzhou , China. 8. h Department of Respiratory Disease , Guangzhou Women and Children's Medical Center , Guangzhou , China. 9. i Department of Respiratory Disease , Children's Hospital of Soochow University , Suzhou , China. 10. j Guangzhou Institute of Respiratory Disease , Guangzhou , China.
Abstract
OBJECTIVE: Asthma afflicts many children in China but information about asthma management among Chinese pediatric asthma patients is limited. This study aims to evaluate asthma control among Chinese pediatric patients and identify risk factors associated with uncontrolled asthma. METHODS: A total of 4223 patients with persistent asthma aged 2-16 years from 42 tertiary hospitals across all regions of mainland China except Tibet were surveyed. Asthma Control Test (ACT), Childhood Asthma Control Test (C-ACT) and Global Initiative for Asthma (GINA) criteria were used to assess asthma control for children aged 12-16 years, 4-11 years and 2-3 years, respectively. Uncontrolled asthma was defined as ACT or C-ACT score ≤19 or GINA-defined uncontrolled asthma. Risk factors associated with uncontrolled asthma were identified using multivariate logistic regression models. RESULTS: Asthma was uncontrolled in 19.9% of the subjects. High rates of uncontrolled asthma were found in subjects with treatment non-adherence (44.1%), concomitant allergic rhinitis (AR) (23.3%), disease duration ≥ 1.5 years (22.8%), and first-degree relatives with AR (21.5%). The risk of uncontrolled asthma was much higher in the treatment non-adherence group compared to the complete adherence group (OR = 5.79, p < 0.001). Concomitant AR, disease duration ≥ 1.5 years, and first-degree relatives with AR were also confirmed as risk factors associated with uncontrolled asthma. CONCLUSIONS: About 20% of Chinese pediatric asthma patients had uncontrolled asthma. Treatment adherence and AR were the most significant risk factors. Tailored measures aimed at improving treatment adherence and diagnosis and treatment of AR should be adopted to improve the level of asthma control in Chinese children.
OBJECTIVE:Asthma afflicts many children in China but information about asthma management among Chinese pediatric asthmapatients is limited. This study aims to evaluate asthma control among Chinese pediatric patients and identify risk factors associated with uncontrolled asthma. METHODS: A total of 4223 patients with persistent asthma aged 2-16 years from 42 tertiary hospitals across all regions of mainland China except Tibet were surveyed. Asthma Control Test (ACT), Childhood Asthma Control Test (C-ACT) and Global Initiative for Asthma (GINA) criteria were used to assess asthma control for children aged 12-16 years, 4-11 years and 2-3 years, respectively. Uncontrolled asthma was defined as ACT or C-ACT score ≤19 or GINA-defined uncontrolled asthma. Risk factors associated with uncontrolled asthma were identified using multivariate logistic regression models. RESULTS:Asthma was uncontrolled in 19.9% of the subjects. High rates of uncontrolled asthma were found in subjects with treatment non-adherence (44.1%), concomitant allergic rhinitis (AR) (23.3%), disease duration ≥ 1.5 years (22.8%), and first-degree relatives with AR (21.5%). The risk of uncontrolled asthma was much higher in the treatment non-adherence group compared to the complete adherence group (OR = 5.79, p < 0.001). Concomitant AR, disease duration ≥ 1.5 years, and first-degree relatives with AR were also confirmed as risk factors associated with uncontrolled asthma. CONCLUSIONS: About 20% of Chinese pediatric asthmapatients had uncontrolled asthma. Treatment adherence and AR were the most significant risk factors. Tailored measures aimed at improving treatment adherence and diagnosis and treatment of AR should be adopted to improve the level of asthma control in Chinese children.