Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc
Journal website http://www.jocmr.org

Original Article

Volume 12, Number 6, June 2020, pages 362-368


Outpatient Management of Bronchial Asthma: A Comparative Analysis Between Guideline-Directed Management and Usual Management

Figure

Figure 1.
Figure 1. Frequencies of number of exacerbations per year.

Tables

Table 1. Demographics and Clinical Characteristics
 
VariableGuideline-directed medical therapy (n = 139)Usual medical therapy (n = 161)P
aIndependent t-test; bChi-square and Fisher’s exact test. NS: not significant; BMI: body mass index; SD: standard deviation.
Age (years), mean (SD)56.7 (15.6)56.7 (15.8)0.986a
Gender
  Male (n, %)40 (28.8)45 (28)0.874b
  Female (n, %)99 (71.2)116 (72)0.874b
Race0.796b
  White (n, %)88 (63.3)107 (66.5)
  Black (n, %)24 (17.3)22 (13.7)
  Hispanic (n, %)21 (15.1)23 (14.3)
  Asian (n, %)6 (4.3)9 (5.6)
Social factor, cigarette smoking (n, %)52 (37.4)71 (44.1)0.240b
BMI (kg/m2), mean (SD)32.1 (8.3)31.6 (7.2)0.635a
Asthma severity0.394b
  Mild (n, %)131 (94.2)155 (96.3)
  Moderate (n, %)8 (5.8)5 (3.1)
  Severe (n, %)0 (0.0)1 (0.6)

 

Table 2. Associated Comorbid Conditions
 
VariableGuideline-directed medical therapy (n = 139)Usual medical therapy (n = 161)Pa
aChi-square and Fisher’s exact test. CHF: congestive heart failure; ESRD: end-stage renal disease; ESLD: end-stage liver disease; GERD: gastroesophageal reflux disorder; COPD: chronic obstructive pulmonary disease.
CHF (n, %)14 (10.1)16 (9.9)0.969
ESRD (n, %)1 (0.7)0 (0.0)0.463
ESLD (n, %)3 (2.2)2 (1.2)0.537
Anemia (n, %)22 (15.8)27 (16.8)0.826
Rheumatoid arthritis (n, %)5 (3.6)10 (6.2)0.300
Multisystem rheumatic disorder (n, %)12 (8.6)9 (5.6)0.303
Psychiatric diseases (n, %)50 (36.0)82 (50.9)0.650
GERD (n, %)61 (43.9)75 (46.6)0.640
COPD (n, %)11 (7.9)19 (11.8)0.263
Allergic rhinitis (n, %)52 (5.8)63 (39.1)0.760
Atopic dermatitis (n, %)8 (17.6)14 (8.7)0.330
Nasal polyp (n, %)1 (0.7)1 (0.6)1.000
Eosinophilia (n, %)10 (8.6)12 (9.0)0.926

 

Table 3. Comorbidities and Relation to Exacerbations
 
VariableOdds ratioa95% confidence interval odds ratio
LowerUpper
aLogistic regression. BMI: body mass index; COPD: chronic obstructive pulmonary disease; CHF: congestive heart failure; ESLD: end-stage liver disease; GERD: gastroesophageal reflux disorder.
Age1.020.991.04
Race
  Caucasian vs. black1.060.462.44
  Caucasian vs. Hispanic0.930.382.25
  Caucasian vs. Asian1.990.507.94
BMI1.030.991.07
COPD overlap2.7550.809.45
CHF4.341.2515.01
ESLD0.170.013.78
Rheumatoid arthritis0.860.213.56
Multisystem disease1.240.354.43
Psychiatric disease0.870.451.65
GERD0.920.481.78
Asthma severity9.724.8319.60
Smoking history1.480.792.79
Allergic rhinitis2.041.034.03
Atopic dermatitis1.100.244.99
Nasal polyps1.710.0933.20
Eosinophilia0.600.182.00

 

Table 4. Medications Prescribed
 
MedicationGuideline-directed medical therapy (n = 139)Usual medical therapy (n = 161)Pa
aChi-square and Fisher’s exact test.
Short-acting beta agonist (n, %)138 (99.3)83 (51.6)< 0.001
Inhaled corticosteroid (n, %)69 (49.6)54 (33.5)0.005
  Low (n, %)15 (10.8)19 (11.8)
  Medium (n, %)27 (19.4)22 (13.7)
  High (n, %)27 (19.4)13 (8.1)
Long-acting beta agonist (n, %)48 (34.5)34 (21.1)0.009
Long-acting muscarinic antagonist (n, %)3 (2.2)16 (9.9)0.006
Leukotriene inhibitor (n, %)23 (16.5)61 (37.9)< 0.001
Omalizumab (n, %)2 (1.4)0 (0.0)0.214

 

Table 5. Exacerbations and Hospitalizations
 
Patient outcomeGuideline-directed medical therapy (n = 139)Usual medical therapy (n = 161)Pa
aa aIndependent t-test.
Number of exacerbations0.034
  0 (n, %)72 (51.8)109 (67.7)
  1 (n, %)61 (43.9)47 (29.2)
  2 (n, %)5 (3.6)3 (1.9)
  3 (n, %)1 (0.7)2 (1.2)
Number of hospitalizations0.349
  0 (n, %)131 (94.2)155 (96.3)
  1 (n, %)8 (5.8)5 (3.1)
  2 (n, %)0 (0.0)1 (0.6)