Detection Of Treatment Adherence, Disease Control and Its Predictors in Asthma Patients by Rural Community Level Health Workers

Background: Despite the availability of effective therapy, disease control in Asthma remains suboptimal with high morbidity. Objectives: To assess treatment adherence, asthma control and its influencing fac-tors.Methodology: A prospective, observational study was conducted among 152 adult asthma patients re-porting consecutively to a BPHC for twelve months. Patients were followed up by trained healthcare workers to assess their treatment adherence and disease control using a predesigned, pretested and val-idated questionnaire.Results: Mean age was 49.6 years (SD=+14.0), males reported more cases (73.7%), addiction to tobacco was high (48.7%). 40.8% patients had high treatment adherence. Only 37.5% patients reported good asthma control of which 68.4% showed high adherence. The mean Asthma Control Test (ACT) score was 18.75 ± 4.8 SD. Increasing age (aOR=0.96, 95% CI= 0.93-0.99), tobacco smoking (aOR=2.90, 95% CI=1.20-6.99), dust allergy (aOR= 7.92, CI =3.15-19.91) and low treatment adherence (aOR=5.33, 95% CI=2.22-12.82) were found to be significant predictors of poor disease control.Conclusions: Non adherence to treatment and poor disease control was high among rural asthma pa-tients. Patient education for tobacco cessation and treatment compliance along with periodic monitoring undertaken by trained health workers can be an effective strategy to reduce disease burden in the com-munity.