Uncontrolled asthma and its risk factors in adult Chinese asthma patients.
Asthma affects a large number of patients in China, but relatively little is known about asthma management among Chinese patients. This study aims to estimate asthma control rate among adult Chinese patients and to identify predictors associated with uncontrolled asthma.



A total of 4125 asthma patients aged ⩾17 years and representing all regions of mainland China except Tibet were surveyed. Asthma control status was assessed using the Asthma Control Test (ACT) and classified as controlled (ACT score ⩾ 20) and uncontrolled (ACT score ⩽ 19). A multivariate logistic regression model was used to identify predictors associated with uncontrolled asthma from the factors including demographics, rhinitis, allergic rhinitis, and treatment adherence.



Asthma was controlled in 44.9%, and uncontrolled in 55.1% of the study participants. High rates of uncontrolled asthma were found in patients with treatment nonadherence (77.3%), poor adherence (66.2%), no schooling (64.8%), or obesity (62.9%). The risk of uncontrolled asthma was much higher in the treatment nonadherence group than the complete adherence group [odds ratio (OR) = 4.55 (3.68-5.62), p < 0.001]. Other predictors for uncontrolled asthma included concomitant rhinitis [OR = 1.31 (1.14-1.50), p < 0.001], obesity [OR = 1.31 (1.05-1.64), p = 0.019], asthma duration > 3 years [OR = 1.22 (1.07-1.39), p = 0.004] and age ⩾ 45 years [OR = 1.23 (1.07-1.41), p = 0.004].



About half of the participants in this study had uncontrolled asthma. Treatment nonadherence is one of the significant predictors, which is very strongly associated with uncontrolled asthma. Efforts should be prioritized to promote patients' treatment adherence to improve asthma control while attention is needed on rhinitis or obesity.
Department of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiang Rd., 510120 Guangzhou, China nanshan_zhong9@126.com.
Nanshan
N
Zhong
Department of Respiratory Disease, China-Japan Friendship Hospital, Beijing, China.
Jiangtao
J
Lin
Department of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Jinping
J
Zheng
Department of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Kefang
K
Lai
Department of Respiratory Disease, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
Canmao
C
Xie
Department of Respiratory Disease, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
Ke-Jing
KJ
Tang
Department of Respiratory Disease, Jiangsu Provincial People's Hospital, Nanjing, China.
Mao
M
Huang
Department of Respiratory Disease, The General Hospital of Shenyang Military Region, Shenyang, China.
Ping
P
Chen
Department of Respiratory Disease, Xinqiao Hospital, The Third Military Medical University, Chongqing, China.
Changzheng
C
Wang
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage*; D001249:Asthma / Q000188:drug therapy* / Q000453:epidemiology; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000453:epidemiology; D012220:Rhinitis / Q000453:epidemiology*; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult
D018927:Anti-Asthmatic Agents
adult; asthma; cross-sectional studies; risk factors