Assessment of asthma control and associated risk factors: findings from the Klang Asthma Cohort Study in Malaysia

Aim Asthma control is unsatisfactory despite availability of effective treatment. This study aimed to examine patients’ asthma control and the associated risk factors in the Klang Asthma cohort of 1,280 patients (85.3% adults (35% male), and 14.7% children (55% male) with physician-diagnosed asthma or given asthma treatment in the preceding year, attending six public primary care clinics in Klang District, Malaysia.MethodsData were collected face-to-face at the time of recruitment to the Klang asthma cohort using questionnaires and the patients’ clinic records. Assessment of asthma control was based GINA 2017. Stepwise logistic regression was used to identify possible risk factors associated with poorly controlled asthma.ResultsOf the 1,092 adults, only 372 (34.1%) had good asthma control, 399 (36.5%) and 321 (29.4%) had partly and uncontrolled asthma, respectively. Of 188 children, 102 (54.3%) had good control, 60 (31.9%) had partly controlled and 26 (13.8%) had uncontrolled asthma.In adults, factors associated with poorly controlled asthma were: use of short-acting bronchodilator (SABA) in the past month (OR 4.5; 95% CI 3.3-6.1); self-reported exposure to haze (OR 1.5; 95% CI 1.1-1.9); extreme emotion as trigger (OR 1.6; 95% CI 1.1-2.5); air-conditioning as trigger (OR 1.6; 95% CI 1.2-2.2), doing sports (OR 2.4; 95% CI 1.8-3.3) and male (OR 1.4; 95% CI 1.1-1.9). Conversely, the odds of a complementary medicine (CAM) user having good control was 1.62 (95% CI 1.1-2.3) compared to non-user.In children, the factors associated with poor control were: use of SABA in the past month (OR 12.3; 95% CI 5.5-27.8) and attending secondary level education (OR 2.9; 95% CI 1.2-6.6).ConclusionAsthma control remains suboptimal. The use of SABA is still prevalent and a strong association for poor asthma control in both adults and children. A number of triggers were identified and deserve attention in asthma reviews. Implementation Science/Service Development Research Ideas on Respiratory Conditions and Tobacco Dependency Abstract Declaration of Interest This research was commissioned by the UK National Institute for Health Research (NIHR) Global Health Research Unit on Respiratory Health (RESPIRE), using UK Aid from the UK Government to support global health research. References and Clinical Trial Registry Information