Survey: Patients Lack Confidence in Managing Their Asthma Care

FAIRFAX, Va. — A recent survey entitled Perceptions of Asthma Care, conducted by Allergy & Asthma Network Mothers of Asthmatics (AANMA), reveals that patients and physicians have different perceptions when it comes to a variety of issues in asthma care. Physicians' attempts to classify asthma severity as mild, moderate or severe do not necessarily help patients get the proper treatment or control their asthma in the most effective way.

Classification of asthma severity may be problematic, as the data indicate that physicians believe mild-to-moderate asthma patients are not taking their disease seriously; however, 21 percent of those same patients reported at least one asthma-related emergency room visit in the last six months.

One of the most staggering survey findings is that less than half of patients feel confident in their ability to manage or prevent symptoms, which can probably be attributed to patients not feeling as though they have been given enough information about their condition.

"It is critical for patients to request a written asthma management plan and review it with their doctor. Patients and physicians should update the plan each year, or as symptoms worsen or improve," said Nancy Sander, founder and president of AANMA. The survey found that in the absence of a written plan, patients often begin adapting their use of medication without consulting their physician. In fact, almost half (46 percent) of all patients surveyed with mild asthma said they did not receive an asthma management plan.

The survey also revealed that while physicians believe that the primary causes of emergency room visits among their asthma patients are missed doses of daily medications and failure to keep doctor visits, patients believe that they are following their medication instructions and blame the visits on exposure to asthma triggers and medication failures. Physicians believe that approximately 20 percent of their mild-to-moderate asthma patients are taking more than is prescribed of their bronchodilator medication; however, only 4 to 6 percent of patients report taking more than prescribed. This means that almost 40 percent of the patients surveyed are misusing their asthma medication.

"Patient and physician asthma vocabularies are not in sync. What patients may not understand, or even hear, when they talk to their asthma physician is that asthma is a complex and evolving condition requiring regular assessment and monitoring," added Sander. "For example, when physicians say 'mild asthma,' patients hear 'no big deal,' which is simply not the case. It's a chronic and life-threatening disease that affects lung function, which is vital to life," continued Sander.

The data reveal that national treatment guidelines intended to help direct treatment decisions by categorizing severity may instead leave patients and physicians with different expectations for their disease. "National treatment guidelines from NHLBI (National Heart, Lung, and Blood Institute) that define 'mild-moderate-severe' are intended to help physicians make treatment decisions," said John Oppenheimer, M.D., director of clinical research, pulmonary and allergy associates, Summit, N.J. "Instead, the definitions may leave patients and physicians with different expectations about what to do about the disease and its symptoms."

Oppenheimer continued, "Well-controlled asthma is a realistic goal for most patients. Physicians, in partnership with patients, should set realistic targets for asthma control while balancing the risks and benefits of therapy. Treatment goals and treatment programs should both be individualized for each patient."

According to the National Center of Health Statistics, more than 20 million adults and 9 million children in the United States have been diagnosed with asthma. This survey was conducted by Harris Interactive on behalf of the AANMA and the American College of Allergy, Asthma & Immunology (ACAAI) and with the support of an unrestricted educational grant from Sepracor Inc. The survey was conducted online between September to November 2005, and included 619 patients (ages 18-64 who used a bronchodilator within the past six months) and 306 physicians (primary care providers, pulmonologists, allergists and immunologists).

For a consumer resource, visit www.breatherville.org.

Source: Allergy & Asthma Network Mothers of Asthmatics

This article originally appeared in the April 2006 issue of HME Business.

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