Background Psychosocial factors play an important role in outcomes from asthma, as in many chronic disease states. Perceived control, a measure of patients' beliefs about their ability to control their disease, has not been studied in association with asthma health care utilization.
Methods We used data from a prospective cohort study of patients who were hospitalized for asthma (n = 865). After hospital discharge, we conducted structured telephone interviews to obtain demographic characteristics, asthma history, and psychological variables, including the Perceived Control of Asthma Questionnaire (PCAQ). We then used a computerized utilization database to prospectively measure rates of emergency department visits and hospitalizations for asthma over the ensuing 4 years.
Results After controlling for age, gender, socioeconomic status, educational level, and other demographic factors, greater perceived control was associated with a significantly decreased prospective risk of emergency department visits (HR 0.92, 95% CI 0.86-0.98, p = .008) and hospitalization for asthma (HR 0.84, 95% CI 0.78-0.90, p < .0001). There was no association, however, found between perceived control and most aspects of preventive care or self-management.
Conclusions Greater perceived control of asthma is associated with a decreased prospective risk of severe asthma attacks resulting in emergency health care utilization for asthma, even after controlling for asthma severity. This difference does not appear to be mediated by changes in preventive care or asthma self-management practices.
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