Prevalence of asthma-triggering drug use in adults and its impact on asthma control

Moufag Mohammed Saeed Tayeb, Mohammed Abdullah M Aldini, Azzam Khalid A Laskar, Ibrahim Ahmed M Alnashri, Sultan Khalid A Abdullah, Abdullah Hussaen A Almalki, Ahmad Ayed A Derham, Turki Mohammed M Alotaibi, Anas Muwaffaq Tayeb


The use of asthma-triggering drugs (ATDs) is a major factor in poor asthma control (PAC), which can be either uncontrolled or partially controlled. ATDs include angiotensin-converting enzyme (ACE) inhibitors, β-blockers, aspirin, and nonsteroidal anti-inflammatory drugs (NSAIDs).

To measure the prevalence of ATD use in adult asthmatics and their control levels.

This is a one-year cross-sectional study (starting March 2016). A sample of 173 adult asthmatics (mean age: 44±16 years) was enrolled from five primary care centres in Jeddah city (Saudi Arabia). Asthmatics were clinically diagnosed according to the British Thoracic Society’s asthma guidelines. Chronic obstructive pulmonary disease was excluded by reversibility (i.e., symptom improvement after using asthma drugs). The four questions about asthma control from the Global Initiative for Asthma’s 2016 guidelines were translated to Arabic, photos and names of ATDs available in local pharmacies were collected, and a questionnaire was drafted. The questionnaire was presented to adult asthmatics by medical students during a personal interview. Data were statistically analysed using SPSS.

Fifty percent of the adult asthmatics who used ATDs had badly controlled asthma: 31 per cent uncontrolled and 19 per cent partially controlled. Of the patients who took ATDs, 97 per cent had used several ATDs for extended periods of time without any warnings from health professionals. In order of prevalence, aspirin, ACE inhibitors, other NSAIDs, and β-blockers were the most common ATDs used.

ATDs are a major cause of PAC. ATD use is extensive and often goes unnoticed. The present findings highlight the low awareness of health professionals about the undesirable effects of ATDs on asthma control. This problem needs to be resolved by regular and continuous asthma health educational courses. During clinic visits, health professionals should inquire about ATD use, discontinue them, and offer an alternative. This simple action could markedly improve asthma control.
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