Characterization of asthma exacerbations in outpatients – National survey

Background: The control of asthma is important to maintain normal activity. One of the key points in good asthma control is the management of exacerbations. Aim: To characterize asthmatic patients with and without exacerbations (E). Methods: Specially designed questionnaire was used to evaluate asthma patients from around 37 medical practices across the country. Inclusion criteria were >12 months from the first diagnosis of asthma and at least two visits for the last 12 months. Results: The number of asthmatic patients who took part in the study was 540 with mean age of 52±14 and 161 (29.8%) men. Smokers were 30.7% with higher number in patients with E (p<0.05). Mean asthma duration was 14±10 years. From all patients 56% were exacerbators with at least one E in the last 12 months (44% had no E, 31.4% had 1 E and 24.6% had 2 or more E), 18.1% were hospitalized due to asthma E and 10.9% due to comorbidities (CM). Patients with E more often had CM (89.7% vs. 79.1%, p<0.05) and arterial hypertension (50.5% vs 37.3%, p<0.05). The patients with E had higher usage of SABA and leukotriene receptor antagonists (LTRA) per month (p<0.05). Higher usage of SABA was also related with higher usage of theophylline (TEO). In the group of exacerbators patients with hospitalizations had increased usage of TEO and LTRA in comparison with non-hospitalized patients. All patients were treated with inhaled corticosteroids (ICS) – alone or in combination with a long acting beta-2-agonist (LABA). Conclusion: This National survey showed a high rate of asthma E and hospitalizations among patients on regular ICS/ICS+LABA treatment. Smoking and CM (especially arterial hypertension) turned out to be important contributing factors.