Evaluation and determinants of asthma control among adult patients with asthma attending the Johannesburg academic respiratory clinics: A cross-sectional study

Background. The prevalence of asthma in South Africa is among the highest in Africa, but little research has been done regarding levels of asthma control and associated determinants.Objectives. To explore level of asthma control and perceived risk factors associated with poor control in adult patients with asthma attending respiratory clinics at three major hospitals in Johannesburg. Methods. This was a quantitative, descriptive, cross-sectional study of all adult patients attending the clinics. Participants were given a three-section self-reporting survey, consisting of a demographic section, an Asthma Control Test (ACT) questionnaire, and an eight-item Morisky Medication Adherence Scale (MMAS-8) questionnaire. Results. The prevalence of poor asthma control based on participants’ ACT scores in this study was 71.3%. A significant linear regression was identified between the ACT and MMAS-8 scores in the uncontrolled asthma group. Significant associations between asthma control and the sociodemographic factors age, body mass index ≥25 and previous hospitalisation for exacerbation were found. No such associations existed for gender or level of education. In evaluating comorbidities, no significant association was found for hypertension, gastro-oesophageal reflux disease, sinusitis or diabetes mellitus. Of the patients, 89.3% used short-acting beta-agonists and 93.3% inhaled corticosteroids (ICSs); 58.7% were on combined long-acting beta-agonists and ICSs. Conclusion. Asthma control in the study setting was poor. There was also an interesting inverse relationship between control and therapy adherence. Further research is needed to better understand the issues surrounding asthma control and to lay the groundwork for policies to benefit asthma patients in the future.