Asthma patients ‘too accepting of symptoms’

Researchers from the UK report that patients with asthma continue to overestimate their asthma control, and many accept symptoms as the norm.

Noting that the findings echo those of earlier studies, Monica Fletcher (Education for Health, Warwick) and David Hiles (Asthma UK, London) say they highlight “that little progress has been made in recent years in improving patients’ knowledge and understanding of control.”

An online questionnaire completed by 1083 adults with asthma showed that 79% thought their asthma control was “very good” or ‘”good.” However, among these patients, 28% used their reliever inhaler at least once a day, 8% used it at least three times daily, and 58% reported frequent daytime symptoms.

Additionally, among the 91% of respondents who said they were “fairly satisfied” or “very satisfied” with their asthma control, 31% used their reliever on a daily basis.

Most (77%) patients thought their relationship with their healthcare professional (HCP) was “very good” or “good” but 70% believed that it was the patient’s responsibility for ensuring asthma control rather than the HCP’s.

On the whole, the researchers found that respondents accepted their symptoms and did not expect additional help from their HCP, with 86% saying that they expected asthma to always impact on their life and 23% believing their HCP could do nothing more to help.

“Respondents’ low expectations of achieving asthma control and the discrepancy between perceived control and symptoms may reflect misunderstandings regarding the term ‘asthma control,’” comment the authors in the Primary Care Respiratory Journal.

They suggest that patients may consider the term to mean good crisis management, such as knowing what to do when they become symptomatic or have an attack.

“It may be time for a radical rethink about how asthma is managed in primary care,” Fletcher and Hiles write.

“Patients’ needs and behaviours are continually changing, and personalised care (including regular asthma reviews and [personal asthma action plans]) is more important than ever,” they say, adding that efforts should be focused on removing barriers to asthma control, and a sense of shared responsibility between patients and physicians.

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