Assessment of Asthma Control Among Asthmatic Patients at Primary Healthcare Centers in Makkah, Saudi Arabia - A Primary-Care Focused Manuscript

Background: Asthma is a worldwide health problem that affects quality of life and imposes a cost of healthcare in Saudi Arabia. This manuscript assesses asthma control among patients attending primary healthcare centers (PHCCs) in Makkah and highlights primary-care implications using a cross-sectional design. Methods: A cross-sectional study was used in the manuscript. The five stratified PHCCs in Makkah between March and May 2016 were selected; 167 asthmatic patients aged >=4 years were identified. A researcher-designed questionnaire and validated Arabic Asthma Control Test (ACT) instruments for children and adolescents/adults were used to collect data. Asthma control was categorized using ACT cutoffs (controlled, partially controlled, uncontrolled). Descriptive statistics and Chi-square/Fisher exact tests, with significance set at P <= 5%, were used. Results: Overall, 58.6% of respondents had impaired asthma control (uncontrolled or partially controlled), and 41.3% had fully controlled asthma. Children (<12 years) had higher rates of uncontrolled asthma than adolescents/adults (58.3% vs. 24.3%, p <3%). The most common trigger factors were dust (91.6%), incense/detergent/essence exposure (86.8%), common cold (82%), and cold weather (79.6%). Among children, cold weather and exercise were significantly associated with uncontrolled asthma (and, respectively). Non-specialized PHCCs had higher proportions of patients with impaired control than specialized centers. Conclusions: Poor asthma control, particularly in children, was common among PHCC patients in Makkah. Modifiable environmental triggers and gaps in primary-care management were the causes of poor asthma control. To reduce the morbidity and mortality from acute asthma, the study suggested strong guideline-based management, targeted trigger reduction, and structured education for patients and caregivers.