Asthma control and activity limitations: insights from the Real-world Evaluation of Asthma Control and Treatment (REACT) Study

• Published in: Annals of allergy, asthma, & immunology Vol. 104; no. 6; pp. 471 - 477
• Main Authors: Haselkorn, Tmirah, PhD, Chen, Hubert, MD, Miller, Dave P., MS, Fish, James E., MD, Peters, Stephen P., MD, Weiss, Scott T., MD, Jones, Craig A., MD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-06-2010; Elsevier
• Subjects: Adolescent; Adult; Aged; Allergy and Immunology; Asthma - drug therapy; Asthma - physiopathology; Biological and medical sciences; Chronic obstructive pulmonary disease, asthma; Dermatology; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Humans; Male; Medical sciences; Middle Aged; Motor Activity; Multivariate Analysis; Pneumology; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; Young Adult; World; Lung disease; Immunopathology; Immunology; Treatment; Respiratory disease; Dermatology; Bronchus disease; Obstructive pulmonary disease; Biological activity; Asthma; International
• ISSN: 1081-1206; 1534-4436
• DOI: 10.1016/j.anai.2010.04.006

Background Uncontrolled asthma remains prevalent in the United States and confers a substantial burden on the health care system. Objectives To evaluate the association between uncontrolled asthma and activity limitations in a nationally representative sample of patients with moderate-to-severe-treated asthma and to assess the degree to which demographics and comorbidities were associated with activity limitations. Methods Patients who participated in the Real-world Evaluation of Asthma Control and Treatment study were surveyed regarding type and degree of activity limitations in 4 categories: outdoor activity, physical activity, daily activity, and environmental triggers. Information about asthma control, demographics, and comorbidities was collected. Multivariable regression was used to assess the association between uncontrolled asthma and activity limitations while adjusting for demographic characteristics and comorbid conditions. Results Uncontrolled asthma was associated with a greater than 2-fold risk of outdoor (odds ratio [OR], 2.58; 95% confidence interval [CI], 1.90–3.51) or physical (OR, 2.62; 95% CI, 1.90–3.61) activity limitations and a 66% increased risk of daily activity limitations (OR, 1.66; 95% CI, 1.09–2.51). Comorbidities associated with activity limitation included hives, chronic sinusitis, arthritis, gastroesophageal reflux disease, hypercholesterolemia, and depression. The observed associations between uncontrolled asthma and activity limitation remained significant after controlling for demographic characteristics and comorbid conditions. Conclusions Compared with patients with controlled asthma, those with uncontrolled asthma are at higher risk for limitations in outdoor activity, physical activity, and daily activity. To help patients achieve optimal health, asthma management should include routine assessment of activity limitations and assessment and coordinated care for comorbid conditions.