Asthma control, health related quality of life and determinant factors among adults living with Asthma attending at selected public hospitals in Northwestern, Ethiopia: A multicentered cross-sectional study

Abstract

Abstract Background: Asthma is a major public health challenge and characterized by recurrent attacks of breathlessness and wheezing that varies in severity and frequency from person to person. Asthma control and health related quality of life is an important measure of health outcomes of asthmatic patient that reflects the impact of an illness and its treatment from the patient’s perspective. Objective: The aim of this study was to assess the asthma control levels, health related quality of life and its determinants among asthmatic patient at selected public hospitals in northwestern, Ethiopia Method: A multicenter institutional based cross-sectional study was conducted in North western Ethiopia, from May to July, 2021. A systematic random sampling technique was employed. Bivariable

and multivariable ordinal logistic regression and linear regression were conducted to determine variables that are the independent predictors of asthma control and quality of life, respectively. A p-value of <0.05 was considered statistically significant. Result: A total of 409 patients were included in the final analysis. Asthma was controlled in 28.9% of asthmatics while more than half (59.2%) of subjects had good quality of life. Regarding the potential predictor of asthma control level, being male (AOR=6.5,95%CI (1.285,32.445), Married (AOR=3.627,95%CI (1.280,10.275), health care provider adherence to guideline usage (AOR=8.4,95%CI (2.700,26.011) and non-fuel user (AOR=6, 95%CI (1.5,22.5) were variables that increase asthma control. However, non-adherent to medication (AOR=0.169, 95%CI (0.059, 0.481), low level of role of patient enablement (AOR=0.193, (95%CI) (0.075, 0.499) and poor relationship with health care provider (AOR=0.024 ,95%CI (0.002, 0.233) were variables that significantly decrease asthma control level. Concerning to determinants of health-related quality life, asthma control score (?=0.1367, P<0.001), insurance user (?=0.148, P=0.036), high role of patient enablement (?= 0.39, P<0.001), belief to asthma medication (?= (-0.23), P=0.001), health care provides non-adherence to guideline (?= (-0.302), P<0.001) and being house wife (?= (-0.205) P=0.037) were some of significant predictor of health-related quality of life of asthmatic patient. Conclusion: The findings indicated that asthma control remains suboptimal in a large proportion of asthma patients in the study setting. The health-related quality of life among adults with asthma was largely dependent to the level of asthma control. Socio- demographic, clinical, health care related and medication related, variables were significantly associate asthma control and health related quality of life. Therefore, our study highlights multifaced interventions including comprehensive asthma education along with an integrated treatment plan to improve asthma control and quality of life. Key words: Asthma control, Quality of life, Determinant, Ethiopia