Level of control and hospital contacts in persistent asthma

The purpose of this study was to estimate relationships between asthma cont rol and hospital contacts (visits to emergency rooms and hospitalizations) in a group of patients suffering from persistent asthma, after adjustment f or prior use of inhaled corticosteroids. A computerized family practice dat abase was used to identify patients (aged 6-50 years) with persistent asthm a who received asthma therapy from January 1995. The database provided info rmation on patient demographics and drug therapy. Asthma control was estima ted by a survey of patients at the end of a 12-month study period. Frequenc y of hospital contacts during the study period was related to demographics, asthma control, and prescribed doses of inhaled corticosteroids during a p restudy period. Review of computerized medical files of 497 family practice physicians identified 1966 patients with persistent asthma who met the stu dy criteria. Of these patients, 1251 completed the survey (63.6%). Asthma c ontrol was assessed in 1130 patients; it was moderate or poor in 42% of the cases. During the 12-month study period, 14.8% of patients reported at lea st one hospital contact. The level of asthma control was significantly (p < 0.001) associated with hospital contacts. The odds ratio (OR) for hospital contact for good and poor asthma control was 0.5 (95% confidence interval [CI] 0.2-0.7) and 2.2 (95% CI 1.2-4.4), respectively. Asthma control was re lated to hospital contacts independently of use of inhaled corticosteroids before the study period. Overall, control of asthma was not optimal in this population. The occurrence of hospital contacts was closely related with t he level of control. This association was independent of the dose of inhale d corticosteroids prescribed before the study, suggesting that in asthma, h ospital contacts are primarily related to the level of control experienced by the patients.