Determinants for asthma control, quality of life and use of complementary and alternative medicine in asthmatic pediatric patients in four cities
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.
The conjoint survey involved ten Hong Kong pediatric hospitals/units, two Shenzhen hospitals, two Macau hospitals, and two Guangzhou hospitals on asthma control (using Asthma Control Test) and QoL (Pediatric Allergic Disease Quality of Life Questionnaire, PADQLQ). Acceptability of a treatment is graded as very good/good/fair/poor.
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), increased frequency of traditional Chinese medicine use (B = 1.7, P < 0.05), increased 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).
There are some clinical and cultural differences among the four southern Chinese cities within the Guangdong province. This study identifies potentially modifiable environmental and treatment factors associated with poor asthma control and QoL for health-care interventions. Having a smoker in the family is independently associated with poor asthma control and QoL.
KeywordsAsthma Complementary and alternative medicine Control Inhaled bronchodilator Inhaled corticosteroid Pediatric Allergic Disease Quality of Life Questionnaire Smoking Traditional Chinese medicine
KLH is the principal author who coordinated this survey. All co-authors obtained ethical approval from their respective centers and collected and contributed data to this survey. JSCK and MHW were involved in statistical analysis.
A small research grant was provided by Hong Kong Society of Pediatric Respirology and Allergy.
Compliance with ethical standards
Ethical approval was obtained from NTEC CREC for the principal author and the respective ethics committees of all participating centers.
Conflict of interest
The authors report no conflicts of interest.
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