Ways of improving the efficacy of managing comorbid patients with bronchial asthma in outpatient care practice

Current study analyzes the problems and strategies for managing comorbid patients with bronchial asthma (BA) in primary care conditions.

The aim: to assess the prevalence and structure of comorbid pathology in patients with controlled and uncontrolled BA clinical course and to develop an algorithm for optimizing therapy based on an integrative approach.

Material and methods. 148 patients with verified diagnosis of BA were examined: 110 of them were with uncontrolled BA and 38 with controlled asthma. All the participants underwent a comprehensive clinical, laboratory, and instrumental examination, along with correction of their baseline therapy and comorbid conditions.

Results. It is shown that uncontrolled BA was significantly associated with a higher frequency and polymorphism of comorbid conditions, including key ones allergic rhinitis (odds ratio (OR) 2.884), gastroesophageal reflux disease (OR 9.066), arterial hypertension (OR 3.728), obesity (OR 4.124), and coronary heart disease (OR 2.674). An integrative management algorithm was developed and tested, including correction of basic BA therapy, targeted treatment of comorbidities, and interdisciplinary collaboration of specialists. Application of this algorithm resulted in disease control in 85.1% of patients.

Conclusion. Personalized approach implemented through an integrative management algorithm is a key condition for improving the efficacy of BA outpatient care and enables disease control in the vast majority of patients.