title: Factors associated with asthma control among adults in five New England states, 2006-2007.
abstract: BACKGROUND
  Despite the National Asthma Education and Prevention Program (NAEPP) guidelines that specify the goals of asthma control and management strategies, the number of patients with uncontrolled asthma remains high, and factors associated with uncontrolled asthma are unknown.
  
  
  OBJECTIVE
  The aim was to examine the relationship between asthma control and socio-demographic characteristics, health-care access and use, asthma education, and medication use among adults with active asthma residing in New England.
  
  
  METHODS
  Data from the 2006-2007 Behavior Risk Factor Surveillance System Adult Asthma Call-Back Survey were analyzed using multinomial logistic regression. Asthma control was categorized as "well controlled," "not well controlled," or "very poorly controlled" according to the NAEPP guidelines.
  
  
  RESULTS
  Of the respondents (n = 3079), 30% met the criteria for well-controlled asthma, 46% for not well-controlled asthma, and 24% for very poorly controlled asthma. Being of Hispanic ethnicity (odds ratio [OR] = 4.0; 95% confidence interval [CI] = 1.2-13.7), unemployed or unable to work (OR = 17.9; 95% CI = 6.0-53.4), high school educated or less (OR = 2.8; 95% CI = 1.6-4.7), current smokers (OR = 2.5; 95% CI = 1.3-5.1), or being unable to see a doctor or specialist for asthma care or unable to buy medication for asthma because of cost (OR = 7.6; 95% CI = 3.4-17.1) were associated with very poorly controlled asthma. In addition, having Coronary Obstructive Pulmonary Disease (COPD) (OR = 2.6; 95% CI = 1.5-4.5), two or more routine checkups for asthma (OR = 4.5; 95% CI = 2.3-8.9), or an emergency department visit, urgent care facility visit, and hospitalization in the past year (OR = 3.9; 95% CI = 2.1-7.3) were also associated with having very poorly controlled asthma. Using controller medication in the past year (OR = 2.6; 95% CI = 1.6-4.2) and taking a course on how to manage asthma (OR = 3.0; 95% CI = 1.2-7.8) were significantly associated with poor asthma control.
  
  
  CONCLUSIONS
  The high prevalence (70%) of not well-controlled asthma and poorly controlled asthma in this study emphasizes the need to identify factors associated with poor asthma control for development of targeted intervention. A health policy of increasing asthma education, health-care access, and smoking cessation may be effective and result in better asthma control and management.
authors.affiliation: Asthma Program, Health Education Management and Surveillance Section, Connecticut Department of Public Health, Hartford, CT, USA. KNguyen2@cdc.gov
authors.forename: Kimberly
authors.initials: K
authors.lastname: Nguyen
authors.forename: Hatice
authors.initials: H
authors.lastname: Zahran
authors.forename: Shahed
authors.initials: S
authors.lastname: Iqbal
authors.forename: Justin
authors.initials: J
authors.lastname: Peng
authors.forename: Eileen
authors.initials: E
authors.lastname: Boulay
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000706:statistics & numerical data; D001249:Asthma / Q000188:drug therapy / Q000453:epidemiology* / Q000628:therapy*; D040343:Behavioral Risk Factor Surveillance System; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D003710:Demography / Q000706:statistics & numerical data*; D003863:Depression / Q000453:epidemiology; D004522:Educational Status; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D004651:Employment; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009511:New England / Q000453:epidemiology; D010353:Patient Education as Topic / Q000706:statistics & numerical data; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology; D044469:Racial Groups / Q000706:statistics & numerical data; D012907:Smoking / Q000453:epidemiology; D012959:Socioeconomic Factors; D055815:Young Adult