Determinants for asthma control, quality of life and use of complementary and alternative medicine in asthmatic pediatric patients in four cities

Abstract

Background: Asthma is a significant chronic health problem worldwide. Management aims at disease control by reducing functional impairment and exacerbations and improving quality of life (QoL). We report a multi-center study to survey asthma control and QoL in four cities in the Pearl River Delta. Methods: The conjoint survey involved 10 Hong Kong pediatric hospitals/units, 2 Shenzhen hospitals, 2 Macau hospitals and 2 Guangzhou hospitals on asthma control (using Asthma Control Test, ACT) and QoL (Pediatric Allergic Disease Quality of Life Questionnaire, PADQLQ). Acceptability of a treatment is graded as very good/good/fair/poor. Results: Good asthma control was only reported in 80% subjects in Hong Kong but higher in sister cities (85-94%, p<0.001). Allergic rhinitis, “incense burning” and “smoker in family” were prevalent among the four cities. Logistic regression showed better control of asthma was associated with better PADQLQ (B= -0.029, p<0.001), better acceptability of bronchodilator (B= -1.488, p=0.025), negatively with “smoker in family” (B= -0.83, p=0.015) and various PADQLQ domains. Conversely, worse PADQLQ was associated with allergic rhinitis severity (B=4.77; p<0.001), poor control of asthma (B=7.56;p<0.001), increase frequency of traditional Chinese medicine use (B=1.7; p<0.05), increase frequency of bronchodilator usage (B=1.05; p<0.05), “smoker in family” (B=4.05; p<0.05), and incense burning at home (B=3.9; p<0.05). Conclusions: There are some clinical and cultural differences among the four southern Chinese cities within the Canton province. This study identifies potentially modifiable environmental and treatment factors associated with poor asthma control and QoL for healthcare interventions. Having a smoker in the family is independently associated with poor asthma control and QoL.