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

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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 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.

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), 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).

Conclusions

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.

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Funding

A small research grant was provided by Hong Kong Society of Pediatric Respirology and Allergy.

Author information

Authors and Affiliations

  1. Department of Pediatrics, The Chinese University of Hong Kong 6/F Prince of Wales Hospital, Room 84042, Shatin, N.T, Hong Kong SAR, China

    Kam Lun Hon, Kate C. Chan, Jeng Sum C. Kung & Ting Fan Leung

  2. Department of Respiratory Diseases, Shenzhen Children’s Hospital, Shenzhen, 518026, China

    Yan Min Bao & Yue-Jie Zheng

  3. Hong Kong Society of Pediatric Respirology and Allergy, Hong Kong SAR, China

    Kin Wai Chau

  4. Pediatric Respiratory and Sleep Disorders Center, Room 1315D, Argyle Centre Phase 1, 688 Nathan Road, Mongkok, Kowloon, Hong Kong SAR, China

    Kin Wai Chau

  5. Department of Respiration, Guangzhou Women and Children’s Medical Center, Guangzhou, 510623, China

    Rong-Shan Chen, Li Deng & Chun-Hui He

  6. Department of Pediatrics, Kiang Wu Hospital, Macau, China

    Kun Tat Gary Cheok

  7. Department of Pediatrics and Adolescent Medicine, United Christian Hospital, 130, Hip Wo Street, Kwun Tong, Hong Kong SAR, China

    Wa Keung Chiu

  8. Department of Pediatrics, Central Hospital Conde S. Januario, Macau, China

    Kin Mui Ieong

  9. Department of Pediatrics and Adolescent Medicine, Caritas Medical Center, 111, Wing Hong Street, Sham Shui Po, Hong Kong SAR, China

    Ping Lam

  10. Department of Pediatrics and Adolescent Medicine, Tuen Mun Hospital, 23 Tsing Chung Koon Road,Tuen Mun, New Territories, Hong Kong SAR, China

    Shu Yan David Lam

  11. Department of Pediatrics and Adolescent Medicine, Princess Margaret Hospital, 2-10 Princess Margaret Hospital Road, Lai Chi Kok, Kowloon, Hong Kong SAR, China

    Qun Ui Lee

  12. Department of Pediatrics and Adolescent Medicine, Queen Mary Hospital, 102, Pokfulam Road, Hong Kong SAR, China

    So Lun Lee

  13. Department of Pediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China

    So Lun Lee & Theresa N. H. Leung

  14. Department of Pediatrics and Adolescent Medicine, Pamela Youde Nethersole Eastern Hospital, 3, Lok Man Road, Chaiwan, Hong Kong SAR, China

    Theresa N. H. Leung & Lei Shi

  15. Department of Pediatrics, The University of Hong Kong-Shenzhen Hospital, 1, Haiyuan 1st Road, Futian, Shenzhen, China

    Theresa N. H. Leung & Ka Ka Siu

  16. Department of Pediatrics and Adolescent Medicine, Kwong Wah Hospital, 25 Waterloo Road, KLN Hong Kong SAR, China

    Wei-Ping Tan, Ada Y. F. Yip & Daniel K. Ng

  17. Department of Pediatrics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China

    Maggie Haitian Wang & Bao-Jing Wu

  18. JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China

    Maggie Haitian Wang

  19. Department of Pediatrics and Adolescent Medicine, Alice Ho Miu Ling Nethersole Hospital, 11, Chuen On Road, Tai Po, Hong Kong SAR, China

    Tak Wai Wong

Authors
  1. Kam Lun Hon
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  2. Yan Min Bao
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  3. Kate C. Chan
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  4. Kin Wai Chau
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  5. Rong-Shan Chen
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  6. Kun Tat Gary Cheok
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  7. Wa Keung Chiu
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  8. Li Deng
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  9. Chun-Hui He
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  10. Kin Mui Ieong
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  11. Jeng Sum C. Kung
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  12. Ping Lam
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  13. Shu Yan David Lam
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  14. Qun Ui Lee
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  15. So Lun Lee
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  16. Ting Fan Leung
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  17. Theresa N. H. Leung
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  18. Lei Shi
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  19. Ka Ka Siu
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  20. Wei-Ping Tan
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  21. Maggie Haitian Wang
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  22. Tak Wai Wong
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  23. Bao-Jing Wu
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  24. Ada Y. F. Yip
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  25. Yue-Jie Zheng
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  26. Daniel K. Ng
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Contributions

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.

Corresponding author

Correspondence to Kam Lun Hon.

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Ethical approval

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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Hon, K.L., Bao, Y.M., Chan, K.C. et al. Determinants for asthma control, quality of life and use of complementary and alternative medicine in asthmatic pediatric patients in four cities. World J Pediatr 14, 482–491 (2018). https://doi.org/10.1007/s12519-018-0167-1

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