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Yoo, Lee, Uh, Park, Rhee, Oh, and Korean Asthma Study Group: Characteristics of Difficult to Treat Asthma in Korea
Original Article
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2010; 69(5): 361-367.

Published online: 30 November 2010

DOI: https://doi.org/10.4046/trd.2010.69.5.361

Characteristics of Difficult to Treat Asthma in Korea

Kwang Ha Yoo, M.D., Ph.D.1, , Kwan Ho Lee, M.D., Ph.D.2, Soo-Taek Uh, M.D., Ph.D.3, Yong Bum Park, M.D., Ph.D.4, Yang Keun Rhee, M.D., Ph.D.5, Yeon Mok Oh, M.D., Ph.D.6, ; Korean Asthma Study Group

1Department of Internal Medicine, Konkuk University College of Medicine, Seoul, Korea.

2Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea.

3Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Korea.

4Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.

5Department of Internal Medicine, Chonbuk National University College of Medicine, Jeonju, Korea.

6Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Address for correspondence: Yeon-Mok Oh, M.D., Ph.D. Department of Pulmonary and Critical Care Medicine, and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Pungnap 2-dong, Songpa-gu, Seoul 138-736, Korea. Phone: 82-2-3010-3136, Fax: 82-2-3010-6968, ymoh55@amc.seoul.kr

Co-correspondence: Kwang Ha Yoo, M.D., Ph.D. Department of Internal Medicine, Konkuk University Hospital, Konkuk University College of Medicine, 4-12, Hwayang-dong, Gwangjin-gu, Seoul 143-729, Korea. Phone: 82-2-2030-7522, Fax: 82-2-2030-7748, khyou@kuh.ac.kr

Equal contributor:

*Co-corresponding Authors: Kwang Ha Yoo and Yeon-Mok Oh contributed equally to this article.

Received 19 August 2010       Accepted 27 September 2010

Copyright © 2010. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved.

Abstract

Background

Difficult-to-treat asthma afflicts a small percentage of the asthma population. However, these patients remain refractory to treat, and account for 40% to 50% of the health costs of asthma treatment, incurring significant morbidity. We conducted a multi-center cross-sectional study to characterize difficult-to-treat asthma in Korea.

Methods

Subjects with difficult-to-treat asthma and subjects with controlled asthma were recruited from 5 outpatient clinics of referral hospitals. We reviewed medical records of previous 6 months and obtained patient-reported questionnaires composed of treatment compliance, asthma control, and instruments for stress, anxiety, and depression.

Results

We recruited 21 subjects with difficult-to-treat asthma and 110 subjects with controlled asthma into the study. The subjects with difficult-to-treat asthma were associated with longer treatment periods, more increased health care utilization, more medication (oral corticosteroids, number of medication), and more anxiety disorder compared to those of well-controlled asthmatics. There was no difference in age, gender, history of allergy, serum IgE, blood eosinophil count, or body mass index between the 2 groups.

Conclusion

Difficult-to-treat asthma is characterized by increased health care utilization and more co-morbidity of anxiety.

Keywords: Asthma, Therapeutics, Korea, Adrenal Cortex Hormones, Comorbidity

Figures and Tables

Table 1
Demographic characteristics of subjects
trd-69-361-i001

Values are presented as mean±standard deviation unless otherwise indicated.

FEV1: forced expiratory volume in 1 second.

Table 2
Utilization of Health care utility
trd-69-361-i002

Values are presented as mean±standard deviation unless otherwise indicated.

OCS: oral corticosteroid; ICS: inhaled corticosteroid; ACT: asthma control test; OPD: outpatient department; ER: emergency department.

Table 3
Psychological aspects
trd-69-361-i003

Values are presented as mean±standard deviation unless otherwise indicated.

BEPSI: Brief Encounter Psychosocial Instrument; BDI: Beck's Depression Inventory; BAI: Beck's Anxiety Inventory.

Acknowledgements

This study was supported by the Korean Asthma Study Group, the Korean Academy of Tuberculosis and Respiratory Diseases.
This study was supported by MSD Korea. We authors thank the members of the Korean Asthma Study Group, the Korean Academy of Tuberculosis and Respiratory Diseases: Young June Jeon, Yang Keun Rhee, Young Sil Hwang, Kwan Hyoung Kim, Deok Gyum Kim, Hyung Jung Kim, In Won Park, Jae Jeong Shim, Seoo Taek Uh, Yeon-Mok Oh, Kwang Ha Yoo, Jee Hong Yoo, Kwan Ho Lee, Yong Chul Lee, Kwang Ho In, Seong Yong Lim, Jung Hyun Chang, and Ki Suck Jung.

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