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Anxiety and the management of asthma in an adult outpatient population

Department of Pharmacy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta, maria.cordina{at}um.edu.mt

Anthony G. Fenech

Department of Clinical Pharmacology and Therapeutics, Faculty of Medicine and Surgery, University of Malta, Msida, Malta

Josanne Vassallo

Department of Medicine, Faculty of Medicine and Surgery, University of Malta, Msida, Malta

Joseph M. Cacciottolo

Department of Medicine, Faculty of Medicine and Surgery, University of Malta, Msida, Malta

Background: Review of the literature suggests that anxiety is more common among patients with asthma than among the general population, yet it does not appear to be given the attention it deserves as part of the overall management of asthma. The aim of this study was to investigate the relationship between anxiety and asthma management, in terms of Global Initiative for Asthma steps, lung function and medication.

Methods: A total of 201 consecutive patients with respiratory physician-diagnosed asthma were recruited from an adult outpatient asthma clinic. Participants underwent a sociodemographic review, and a medical interview which included a detailed drug history. Forced expiratory volume in 1 second (FEV₁) and peak expiratory flow (PEF) values were recorded using a Micro Medical^® portable spirometer. The level of anxiety was assessed using the Beck Anxiety Inventory (BAI).

Results: A total of 51.5% of participants registered clinically significant levels of anxiety. Of these only 21% had already been diagnosed and were receiving treatment. Females reported significantly higher BAI scores than males (p < 0.01). More females (66.3%) registered clinically significant levels of anxiety as compared with males (33.7%) (p < 0.05). There was a positive correlation between the BAI score and the prescribed dose of inhaled glucocorticoids (r_s = 0.150, p < 0.05) and between anxiety and GINA treatment step (r_s = 0.139, p < 0.05). There was also a positive correlation between anxiety and the number of medicines taken by patients (r_s = 0.259, p < 0.001).

Conclusions: Physicians treating patients with asthma should be sensitised to the association between asthma and anxiety, and should also consider assessing patients for the possibility of anxiety disorders as part of asthma management plans.

Key Words: asthma • anxiety • lung function • medication

This version was published on October 1, 2009

Therapeutic Advances in Respiratory Disease, Vol. 3, No. 5, 227-233 (2009)
DOI: 10.1177/1753465809347038


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