J Asthma. 2023 Nov 24:1-19. doi: 10.1080/02770903.2023.2288317. Online ahead of print.
ABSTRACT
Objective: We aim to assess the risk factors of uncontrolled asthma in children and adolescents. Method: A systemic search was conducted from electronic databases (PubMed/Medline, Cochrane Library, and Google Scholar) from inception to July 17, 2023. All statistical analyses were conducted in Review Manager 5.4.1. Studies meeting inclusion criteria were selected. A random-effect model was used when heterogeneity was seen to pool the studies, and the result was reported in the Odds Ratio (OR) and the corresponding 95% confidence interval (CI). We also used a narrative approach where it was not feasible to quantitatively assess the outcome. Results: Ten observational studies were used to conduct this systematic review and meta-analysis. A quantitative analysis of five factors was done. Pooled analysis showed a statistically significant risk of uncontrolled asthma in association with past hypersensitivity reactions (SMD = 1.51 (1.16, 1.98); p = 0.002; I2 = 84%) and incomplete controller adherence (SMD = 3.15 (1.83, 5.41); p < 0.0001; I2 = 94%). While non-significant relation was seen in parental asthma (SMD = 1.23 (0.98, 1.55); p = 0.07; I2 = 15%), oral corticosteroid use (SMD = 0.99 (0.72, 1.36); p = 0.96; I2 = 81%) and education of caregivers (SMD = 0.99 (0.72, 1.36); p = 0.96; I2 = 81%). Some other factors were also discussed qualitatively. Conclusion: Our study shows that some significant risk factors might cause uncontrolled asthma in children and adolescents like past hypersensitivity reactions and incomplete controller adherence.
PMID:37999990 | DOI:10.1080/02770903.2023.2288317
