ABSTRACT:

Background: Asthma is a worldwide problem; about 300 million people are estimated to have the condition. It is still one of the significant health problems worldwide, particularly increasing in developing countries. Although new drugs and evidence-based guidelines have been developed in recent years, there is still a challenge in reducing asthma morbidity and mortality, and Asthma continues to be under-treated.
Objective: To evaluate the treatment strategies and clinical outcomes among asthmatic patients at Yekatit 12 Hospital in 2022.
Method: A retrospective cross-sectional study was conducted using the medical records of asthmatic patients who attended Yekatite 12 Hospital Medical College in 2022. The study covered the past two years (January 1, 2020 – January 1, 2022 G.C.). Systematic random sampling was employed to select the study subjects. A total of 210 patient records were reviewed.
Result: Of the 210 asthmatic patients studied, 118 (56.2%) had poorly controlled asthma, while the remaining 92 (43.8%) had well-controlled asthma. Among anti-asthmatic drugs, the most prescribed medication was short-acting Beta2-agonists, accounting for 63.80% of the total prescribed anti-asthma drugs—salbutamol puff (34.09%) and oral salbutamol (27.91%). Inhaled corticosteroids accounted for only 15.58%. The most effective anti-asthmatic drug combination was a short-acting Beta2-agonist plus Prednisolone, which was prescribed to 39.57% of asthmatic patients. Overall, 56.2% of asthma patients had poorly controlled asthma, while the rest had well-controlled asthma. There is a statistically significant association between social drug use and treatment outcomes (p-value = 0.031). According to GINA guidelines, the recommended treatment option for children older than six, adolescents, and adults is a combination of a low-dose inhaled corticosteroid (ICS) with an inhaled long-acting Beta2-agonist (LABA), either as a combination inhaler or as separate components.

REFERENCES :

1) Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention. NIH publication, Bethesda, National Institutes of Health, 2006.
2) Sarah Aldington and Richard Beasley. Assessment and management of severe asthma in adults in hospital. PMC, 2007: 62(5), 447-458.
3) Alkhansa Abdel-Amid, Abdelmoneim Awad, Abdellatif Gismallah. Evaluation of hospital pharmacy-based pharmaceutical care services for asthma patients. SciELO, 2008: 8(1), 40-52.
4) Bonnie J. Bereznicki, Lucy C. Norton, Sean A. Beggs, Peter Gee, and Luke R.E. Bereznicki. Review of the management of childhood asthma in Tasmania. Journal of Paediatrics and Child Health, 2013: 20(2), 10-30.
5) Aline Arlindo Vieira, Ilka Lope. Anxiety and depression in asthma patients impact on asthma control. Bras. Pneumol, 2011: 37(1), 32-40.
6) Yemaneberhan H., Bekele Z., Venn A., Lewis S., Eldryd Parry, and John Britton. Prevalence of wheeze and asthma and relation to atopy in urban and rural Ethiopia. LANCET, 1997: 350(9071), 85–907.
7) Hailu S., Michael T., and Silverman. Prevalence of symptoms of asthma and allergies in schoolchildren. Lancet, 2003: 35(6), 427-432.
8) Wjst M., Boakye D. Asthma in Africa. PLoS, or Medicine 2007: 4(2), 72-80.
9) Kate A. Stewart, Patricia C. Higgins, Catherine G. McLaughlin, and Thomas V. William. Differences in prevalence, treatment, and outcomes of asthma among a diverse population of children with equal access to care. JAMA pediatrics, 2010: 164, (8), 720-726. 
10) Amira A. Zekir, Justin Oldham, Machelle Wilson, and Olqa Fortenko. Statin use and asthma control in patients with severe asthma. BMJ, 2013: 3(8), 44-55.
11) J.B. Kirenga and M. Okot-Nwang. The proportion of asthma and patterns of asthma medication prescriptions among adult patients. PMC, 2012: 12, (1), 48-53.
12) Min-Gyu Kang, Joo-Young Kim, Jae-Woo Jung, Woo-Jung, Song Sang-Heon, and Hye-Ryun Kan. Causes and clinical outcomes of non-adherence to outpatient treatment in adult asthmatic patients in Korea. US National Library of Medicine National Institutes of Health 2013: 5(6), 357-245.
13) Alberto Papi, Massima Corradi, Catherine Pigeon-Francisco, and Roberta Barunjo. Beclometasone-formoterol as maintenance and reliever treatment in patients with asthma. Lancet, 2007: 1(1), 23-31.
14) Buston K. Mwood. Noncompliance among adolescents with asthma. International Journal of Pharmaceutical Science Review and Research, 2000: 17(2), 134-138.
15) Desalu O.O., Fawibe A.E., Salami A.K. Assessment of the level of asthma control among adult patients in two tertiary care centers in Nigeria. US National Library of Medicine National Institutes of Health, 2012: 49(2), 765-772.
16) Pauwels R.A., Löfdahl C.G., Postma D.S., Tattersfield A.E., O›Byrne P., Barnes P.J., et al. Effect of inhaled formoterol and budesonide on exacerbations of asthma. Formoterol and Corticosteroids Establishing Therapy (FACET) International Study Group. N Engl J Med, 1997: 337(12), 1405-11.
17) Mark D., Eisner K., Carlos I. The influence of cigarette smoking on adult asthma outcomes. Lancet, 2007: 9(1), 53–56.
18) Liou A., et al. Causative and contributive factors to asthma severity and patterns of medication use in patients seeking specialized asthma care. Afr Health Sci, 2012: 12(1), 48–53.
19) Victor Aniedi Umoh, John U. Ekott, Mfon Ekwere, Obeten Ekpo. Asthma control among patients in Uyo, South-Eastern Nigeria. Indian Journal of Allergy, Asthma, and Immunology, 2013: 27(1), 27-32.
20) Yemaneberhan H., Bekele Z., Venn A., Lewis S., Parry E., Britton J. Prevalence of wheeze and asthma and relation to atopy in urban and rural Ethiopia. Lancet, 1997: 350(5), 85–90.
21) Melaku K., Berhane Y. Prevalence of wheeze and asthma-related symptoms among schoolchildren in Addis Ababa, Ethiopia. Ethiop Med J, 1999; 37(3): 247–254.
22) Admasu Dalo, Raghavendra Yarlagadda, Ramanjireddy Tatiparthi. Assessment of asthma treatment outcomes among adult outpatients at Nemmh Chest Clinic in Hadiya Zone, Southern Ethiopia.