Asthma Control in Multimorbid Patients

Abstract

Background: The aim of this study was to evaluate the asthma control in multimorbid patients to personalize asthma treatment. Methods and Results: The study involved 237 asthma patients (51 men and 186 women) aged 18 to 78 years (mean age of 52.6±1.3 years). All patients were divided into 3 groups: Group 1 included 59(24.9%) patients with normal body weight (NVW), Group 2 included 69(29.1%) overweight patients, and Group 3 had 109(46.0%) obese patients. The mean BMI was of 23.14±2.84 kg/m2, 27.60±2.58 kg/m2, and 35.82±10.23 kg/m2 in Groups 1, 2, and 3, respectively (F=65.572, P=0.0000). Research methods included numerical rating scale (NRS) for a qualitative assessment of the severity of asthma clinical symptoms, asthma control questionnaire (ACQ-5) to assess asthma control, asthma quality of life questionnaire (AQLQ). Comorbidities were analyzed according to medical records. The mean number of comorbidities among all studied patients was 4.31±0.27: 55(23.2%) people had ≤2 comorbidities, 118(49.8%) people had 3-5 comorbidities, and 64(27.0%) people had ≥6 comorbidities. The Group 3 patients had significantly more comorbidities than patients of Groups 1 and 2 (P=0.000). The mean value of the ACQ-5 results was 0.97±0.32, 1.06±0.53, and 1.82±0.55 in Groups 1, 2, and 3, respectively (F=77.1896, P=0.0000). The level of AC, according to the ACQ-5, had a positive correlation with the number of comorbidities (r=0.5418, P<0.05) and a negative correlation with all scales of the AQLQ: activity limitation (r=-0.6376, P<0.05), symptoms (r=-0.6577, P<0.05); emotional function (r=-0.4535, P<0.05); environmental stimuli (r=-0.4529, P<0.05), and general QOL (r=-0.6504, P<0.05). The asthma course is negatively affected by multimorbidity, which is most pronounced in obese patients. An increase in the number of comorbidities significantly worsens AC in patients of all studied groups, while the worst control level was observed in obese patients. A personalized program for managing multimorbid asthma patients should be developed and implemented, considering the multivariate assessment of treatable signs of disease.