Factors predicting the severity and the degree of symptom control of asthma in a recently diagnosed cohort of adult patients (ASMA study)

Introduction The aim of this cohort study was to describe the evolution of recently diagnosed (<12 months) asthma, and to identify outcome predictive factors. This paper describes the evolution of an adult cohort and the factors related to asthma severity and control. Methods In 1995, 251 chest specialists from throughout France, recruited 347 asthmatic adults (subjects with severe asthama were excluded). 220 eligible patients were examined every four months over a three year period. Data (socio-demographic characteristics, asthma history, results of atopy testing and lung function tests, treatment, drug compliance, respiratory infections, changes in lifestyle and environment, and major life events) were collected by means of detailed stanclardised questionnaires completed by physicians. Asthma severity, recorded one year after study inclusion, and asthma control, assessed at each follow-up, visit in the second and third year, were defined according to the international guidelines. Results The clinical status of these adult patients generally improved rapidly. Asthma severity correlated closely with allergy, with a history of childhood asthma and with sensitisation to indoor allergens. After adjusting for severity, poor asthma control was associated with poor compliance, with respiratory infections, and, to a lesser extent, with animals inside the home. Conclusions This cohort study highlights the association of asthma severity with allergy, and of poor asthma control with poor compliance and respiratory infections.