Interference of psychological factors in difficult-to-control asthma

Summary Background Most patients with asthma can be controlled with suitable medication, but 5–10% of them remain difficult to control despite optimal management. Objective We investigated whether patients with difficult-to-control asthma (DCA) or controlled asthma (CA) differ with respect to psychological factors, such as general control beliefs on life events. Methods DCA was defined as an absence of control despite optimal management. Recent control was measured using the Asthma Control Questionnaire. General control beliefs were investigated using a Locus of Control scale (LOC). Results Patients with DCA had a significantly higher external LOC as compared to patients with CA ( P = 0.01 ). In the DCA group, the hospital admission rate was highly significant in association with the external LOC ( P = 0.004 ) as compared to the internal LOC trend. Conclusion This study showed that patients with DCA had different general control beliefs which might have hampered their management and interfered with their therapeutic adherence. The present findings could enhance management of DCA in a clinical setting.