Assessment of asthma control levels in a tertiary hospital: A cross-sectional study

Entisar S. Alsafwani; Ayed M. Alenazi; Mansour M. Alqwaiee; Khaled A. BaQais; Adel S. Alharbi; Abdullah S. Al-Shamrani

doi:10.15537/smj.2025.46.5.20241038

Article Figures & Data

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Table 1

- Demographic and clinical characteristics of patients at baseline (asthma control level in children aged less than 5 years [N=123]).

Variables	n (%)
Age (years), mean±SD	3.61±1.76
Does the child have another chronic illness?
Yes	37 (30.1)
No	86 (69.9)
During the past 4 weeks has the child visited the emergency room for an asthma attack?
Yes	30 (24.4)
No	93 (75.6)
During the past 4 weeks, has your child been admitted to intensive care for an asthma attack?
Yes	9 (7.3)
No	114 (92.7)
During the past 4 weeks, how many times did you not use your preventive spray?
Never	50 (40.7)
Once or twice	48 (39.0)
More than 3 times	25 (20.3)
Over the past 3 months, how would you describe your child’s adherence to preventive asthma treatments?
Always committed	54 (43.9)
Committed most of the time	35 (28.5)
Committed some of the time	26 (21.1)
Not committed	8 (6.5)

Values are presented as numbers and percentages (%).

SD: standard deviation

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Table 2

- Distribution of patient responses to test for respiratory and asthma control in kids.

Variables	n (%)
During the past 4 weeks, how often has your child been bothered by symptoms of shortness of breath, such as wheezing or coughing?
1 or 2 attacks within 4 weeks	56 (45.5)
2 or 3 shifts per week	10 (8.1)
4 or more episodes per week	3 (2.4)
Not at all	37 (30.1)
One shift per week	17 (13.8)
During the past 4 weeks, how often did your child wake up during sleep with symptoms of shortness of breath, such as wheezing or coughing?
1 or 2 times every 4 weeks	40 (32.5)
2 or 3 times a week	13 (10.6)
4 or more times per week	6 (4.9)
Not at all	58 (47.2)
Once a week	6 (4.9)
During the past 4 weeks, how much did your child’s symptoms of shortness of breath, such as wheezing or coughing, limit his/her ability to play, go to school, or do the usual activities that a child your son/daughter’s age should do?
In abundance	11 (8.9)
moderately	19 (15.4)
Not at all	48 (39.0)
To a small extent	43 (35.0)
Very much	2 (1.6)
During the past 3 months, how often did your child need treatment for respiratory symptoms such as wheezing and coughing with bronchodilator medications such as Ventolin?
2 or 3 times a week	15 (12.2)
4 or more times per week	10 (8.1)
Not at all	28 (22.8)
Once a week	16 (13.0)
2 times every 3 months	54 (43.9)
During the past 12 months, how often has your child needed to take oral corticosteroids for symptoms of difficulty breathing that could not be controlled by other medications?
4 times or more	15 (12.2)
It never happened	60 (48.8)
Once	29 (23.6)
3 times	10 (8.1)
Twice	9 (7.3)
Track scale, median (IQR)	75 (90-60)
Track controlled and uncontrolled asthma
Uncontrolled asthma (track score <80)	63 (51.2)
Controlled asthma (track score ≥80)	60 (48.8)

Values are presented as numbers and percentages (%). IQR: interquartile range

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Table 3

- Examining the association between uncontrolled and controlled asthma and the clinical characteristics of patients.

Variables	Uncontrolled asthma (track score <80)	Controlled asthma (track score ≥80)	P-values
Does the child have another chronic illness?
Yes	16 (25.4)	21 (35.0)	0.246
No	47 (74.6)	39 (65.0)	0.246
Age (years), mean±SD	3.71±2.13	3.50±1.26	0.506
During the past 4 weeks has the child visited the emergency room for an asthma attack?
Yes	25 (39.7)	5 (8.3)	<0.001*
No	38 (60.3)	55 (91.7)	<0.001*
During the past 4 weeks, has your child been admitted to intensive care for an asthma attack?
Yes	5 (7.9)	4 (6.7)	0.787
No	58 (92.1)	56 (93.3)	0.787
During the past 4 weeks, how many times did you not use your preventive spray?
Never	22 (34.9)	28 (46.7)	0.415
Once or twice	27 (42.9)	21 (35.0)
More than 3 times	14 (22.2)	11 (18.3)
Over the past 3 months, how would you describe your child’s adherence to preventive asthma treatments?
Always committed	21 (33.3)	33 (55.0)	0.091
Committed most of the time	21 (33.3)	14 (23.3)
Committed some of the time	17 (27.0)	9 (15.0)
Not committed	4 (6.3)	4 (6.7)

*Statistically significant correlation between emergency room visits and uncontrolled asthma. Values are presented as numbers and percentages (%). SD: standard deviation

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Table 4

- Demographic and clinical characteristics of patients at baseline (asthma control level in children aged 5-12 years [N=261]).

Variables	n (%)
Age (years), mean±SD	9.01±2.31
Does the child have another chronic illness?
Yes	83 (31.8)
No	178 (68.2)
During the past 4 weeks has the child visited the emergency room for an asthma attack?
Yes	58 (22.2)
No	203 (77.8)
During the past 4 weeks, has your child been admitted to intensive care for an asthma attack?
Yes	8 (3.1)
No	253 (96.9)
During the past 4 weeks, how many times did you not use your preventive spray?
Once - twice	92 (35.2)
More than 3 times	77 (29.5)
Not once	92 (35.2)
Over the past 3 months, how would you describe your child’s adherence to preventive asthma treatments?
Always committed	100 (38.3)
Committed most of the time	82 (31.4)
Committed some of the time	60 (23.0)
Not committed at all	19 (7.3)

Values are presented as numbers and percentages (%). SD: standard deviation

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Table 5

- Distribution of patient responses to the childhood asthma control test for children 4-12 years of age.

Variables	n (%)
Q1: How are you doing today with asthma?
Very bad	4 (1.5)
Bad	34 (13.0)
Good	109 (41.8)
Very good	114 (43.7)
Q2: Does asthma cause you problems while playing, running, or exercising?
It’s a big problem. I can’t do what I want to do.	33 (12.6)
It is a problem and I don’t like it.	62 (23.8)
It’s a simple problem and I’m fine.	125 (47.9)
I have no problem.	41 (15.7)
Q3: Do you cough because of asthma?
Yes, at all times.	17 (6.5)
Yes, most of the time.	76 (29.1)
Yes, but sometimes.	138 (52.9)
I never cough at any time.	30 (11.5)
Q4: Do you wake up at night because of asthma?
Yes, at all times.	8 (3.1)
Yes, most of the time.	34 (13.0)
Yes, but sometimes.	115 (44.1)
No, it never happened.	104 (39.8)
Q5: During the past 4 weeks, how many days has your child had daytime asthma symptoms?
11-18 days	31 (11.9)
4-10 days	56 (21.5)
1-3 days	105 (40.2)
Never happened	69 (26.4)
Q6: During the past 4 weeks, how many days has your child suffered from symptoms of wheezing during the day?
11-18 days	22 (8.4)
4-10 days	38 (14.6)
1-3 days	87 (33.3)
Never happened	114 (43.7)
Q7: During the past 4 weeks, how many nights did your child wake up at night due to asthma symptoms?
11-18 days	17 (6.5)
4-10 days	38 (14.6)
1-3 days	85 (32.6)
Never happened	121 (46.4)
Childhood asthma control test
Uncontrolled asthma (C-ACT <19)	90 (34.5)
Controlled asthma (C-ACT ≥19)	171 (65.5)

Values are presented as numbers and percentages (%).

C-ACT: asthma control test

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Table 6

- Investigating the association between uncontrolled and controlled asthma and the clinical characteristics of patients.

Variables	Uncontrolled asthma (C-ACT <19)	Controlled asthma (C-ACT ≥19)	P-values
Age (years)
≤9	50 (55.6)	103 (60.2)	0.275
>9	40 (44.4)	68 (39.8)	0.275
Does the child have another chronic illness?
Yes	30 (33.3)	53 (31.0)	0.700
No	60 (66.7)	118 (69.0)	0.700
During the past 4 weeks, has the child visited the emergency room for an asthma attack?
Yes	41 (45.6)	17 (9.9)	<0.001^*
No	49 (54.4)	154 (90.1)	<0.001^*
During the past 4 weeks, has your child been admitted to intensive care for an asthma attack?
Yes	6 (6.7)	2 (1.2)	0.014^*
No	84 (93.3)	169 (98.8)	0.014^*
During the past 4 weeks, how many times did you not use your preventive spray?
Once - twice	30 (33.3)	62 (36.3)	0.441
More than 3 times	31 (34.4)	46 (26.9)
Not once	29 (32.2)	63 (36.8)
Over the past 3 months, how would you describe your child’s adherence to preventive asthma treatments?
Always committed	25 (27.8)	75 (43.9)	0.063
Committed most of the time	35 (38.9)	47 (27.5)
Committed some of the time	24 (26.7)	36 (21.1)
Not committed at all	6 (6.7)	13 (7.6)

↵* Statistically significant correlation between emergency room visits, admission to intensive care, and uncontrolled asthma. Values are presented as numbers and percentages (%). C-ACT: asthma control test