Assessment of asthma control in primary care.
OBJECTIVE
To determine the prevalence of uncontrolled asthma in patients who are visiting their primary care provider for any reason.


METHODS
This multisite, cross-sectional survey was conducted between January 25 and May 2, 2008. Participants aged > or =18 years were recruited from 35 primary care provider sites. Eligible participants presented to the office for any acute medical, routine, follow-up, or nonmedical reason; had a self-reported physician diagnosis of asthma; used medication to treat asthma in the past year; and had no history of COPD. They completed the Asthma Control Test dagger (ACT) and provided information including demographics, health behaviors, medical history, and asthma medication use. Uncontrolled asthma was defined as ACT score < or =19.


RESULTS
The overall weighted prevalence of uncontrolled asthma in 2238 patients in primary care was 58% (95% confidence interval [CI], 0.56-0.60). Among asthma patients seeking care for a respiratory complaint, 72% (95% CI, 0.68-0.75) had uncontrolled asthma compared to 48% (95% CI, 0.45-0.51) of asthma patients presenting for a non-respiratory reason.


CONCLUSIONS
At the population level, over half of patients with asthma under primary care management had uncontrolled asthma at the time of an office visit. Surprisingly, nearly 50% of patients with asthma who presented for office visits not associated with respiratory-related complaints had uncontrolled asthma. The study results may be influenced by a seasonal effect of upper respiratory infections and by the insurance status of the study respondents. However identifying patients with uncontrolled asthma is important and remains a challenge. Therefore, health care providers should consider evaluating asthma control on a regular basis, regardless of reason for visit.
Mintz
Matthew
M
George Washington University School of Medicine, 2150 Pennsylvania Avenue NW, ACC 2-105B, Washington, DC 20037, USA. mmintz@mfa.gwu.edu
Gilsenan
Alicia W
AW
Bui
Christine L
CL
Ziemiecki
Ryan
R
Stanford
Richard H
RH
Lincourt
William
W
Ortega
Hector
H
D000328:Adult; D001249:Asthma / Q000453:epidemiology / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D011320:Primary Health Care; D014481:United States / Q000453:epidemiology