Factors associated with better asthma control in eastern Austria

Background: Asthma control is an important component of quality of care for asthma patients. The controller-to-total-asthma-medication ratio (CTR) has been evaluated as a reliable asthma control and quality indicator. Aim: To evaluate the effects of a regional “asthma awareness campaign” during 2008 (patient, pharmacy and physician training) on asthma control. Methods: We used a database form a central health insurance (BGKK, covering 70% of the population) to select a cohort (n=1158) with an asthma diagnosis (HEDIS criteria). Data for 2007 and 2008 regarding hospital and physician visits, pulmonary function tests, medication claims, etc. were extracted. The CTR was calculated from the amount of DDDs of controller medication divided by the amount of DDDs of controller and reliever medication. Results: The asthma control for the cohort improved from 2007 to 2008 (CTR: 0.758±0.324 vs 0.769±0.326; 2007 vs 2008; p = 0.01). Predictors of a higher (better) CTR were female sex, performance of pulmonary functions tests, and type of controller medication (combination preparation). No influence was found for the number of physician visits, type of specialist, and age. From 2007 to 2008 there was a strong trend from single preparations (-7%) to combination preparations (+22%) of controller medication leading to higher costs (+10.6%). Analogously, in a subgroup of the cohort (n = 169) the asthma control test (ACT) showed an improvement (20.11±4.29 vs 21.11±3.89; p = 0.02), in particular for questions 2 and 4 regarding exacerbations and reliever medication. Conclusion: Population based data showed that a regional awareness and educational initiative can improve asthma control.