Control del asma en pacientes que acuden a consulta de atención primaria en España (estudio ACTIS)

OBJECTIVE: To assess prevalence of non controlled (ACT- Asthma Control Test < 20) asthma in real world clinical practice in Spain. DESIGN: Observational, cross-sectional study. LOCATION: 58 primary care centers from 13 Autonomous Communities. PARTICIPANTS: Asthma patients attending physicians office to collect repeat prescriptions for continuous treatment (Group A), or due to symptoms worsening (Group B). MAIN MEASUREMENTS: Socio-demographic characteristics (age, gender, education, smoking history), physician's assessment of asthma severity, current treatment for asthma, co-morbidities, healthcare-related resources utilization (primary care or emergency visits, hospitalizations), labour or school absenteeism, ACT score and treatment adherence. RESULTS: 376 patients from group A and 262 from group B were included, 59% female, mean age 45 years, 21% smokers and time since asthma diagnosis 8.9 years. 87% were on short acting beta-2 agonists, 62% long acting beta-2 agonists with inhaled corticosteroids and 13.8% regular inhaled corticosteroids. Poor asthma control was observed in 75.6% from group B and 23.8% from group A; only 5.3% from group A showed total asthma control (ACT = 25). Poorer asthma control was significantly associated with longer disease duration and higher use of resources. CONCLUSIONS: Prevalence of poor asthma control among patients attending due to symptoms worsening continues to be very high even in patients who come to renew their prescription. Poor asthma control is associated to high use of resources and high impact on burden of disease.