A new study published in The Journal of Allergy and Clinical Immunology. In Practice aimed toexamine the rates and relative contributions of co-morbidities and care settings in terms of asthma severity and control among pediatric and adolescent/adult patients in a large national sample.

This study examined de-identified patient data from 28508 unique encounters documented in the Asthma IQ database—obtaining patient level factors (demographics, asthma characteristics, co-morbidities), care setting (primary care physician [PCP] versus specialist physician [Allergist or Pulmonologist]) and guideline-defined levels of asthma control/severity. Rates of co-morbidities were identified by asthma severity and control and by care setting. The odds ratios (ORs) for asthma control and severity were calculated based on each co-morbidity.

The findings revealed that patients seen by specialists versus PCPs, were older and had more severe and poorly controlled asthma. Patients cared by specialists also had more comorbid conditions, including gastroesophageal reflux disease (GERD), rhinosinusitisand obstructive sleep apnea (OSA; Adolescents/Adults only). On the other hand, GERD, smoke exposure, depression(adolescents/adults), rhinosinusitis (children) and the African American race were associated with uncontrolled asthma. Additionally, smoke exposure (children), rhinosinsitis and African American race, were associated with severe disease.

Thus, the results identified several demographics and co-morbidities that are independently associated with specialist care setting, persistent asthma and poor asthma control. It was stated that awareness of these relationships may be helpful for clinicians caring for asthma patients.