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Attitudes and actions of asthma patients on regular maintenance therapy: the INSPIRE study.

Partridge MR, van der Molen T, Myrseth SE, Busse WW - BMC Pulm Med (2006)

Bottom Line: The mean period from the onset to the peak symptoms of a worsening was 5.1 days.Although most patients recognised the early signs of worsenings, the most common response was to increase short-acting beta2-agonist use; inhaled corticosteroids were increased to a lesser extent at the peak of a worsening.However, they often adjust treatment in an inappropriate manner, which represents a window of missed opportunity.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Respiratory Medicine, Faculty of Medicine, Imperial College London, London, UK. m.partridge@imperial.ac.uk

ABSTRACT

Background: This study examined the attitudes and actions of 3415 physician-recruited adults aged > or = 16 years with asthma in eleven countries who were prescribed regular maintenance therapy with inhaled corticosteroids or inhaled corticosteroids plus long-acting beta2-agonists.

Methods: Structured interviews were conducted to assess medication use, asthma control, and patients' ability to recognise and self-manage worsening asthma.

Results: Despite being prescribed regular maintenance therapy, 74% of patients used short-acting beta2-agonists daily and 51% were classified by the Asthma Control Questionnaire as having uncontrolled asthma. Even patients with well-controlled asthma reported an average of 6 worsenings/year. The mean period from the onset to the peak symptoms of a worsening was 5.1 days. Although most patients recognised the early signs of worsenings, the most common response was to increase short-acting beta2-agonist use; inhaled corticosteroids were increased to a lesser extent at the peak of a worsening.

Conclusion: Previous studies of this nature have also reported considerable patient morbidity, but in those studies approximately three-quarters of patients were not receiving regular maintenance therapy and not all had a physician-confirmed diagnosis of asthma. This study shows that patients with asthma receiving regular maintenance therapy still have high levels of inadequately controlled asthma. The study also shows that patients recognise deteriorating asthma control and adjust their medication during episodes of worsening. However, they often adjust treatment in an inappropriate manner, which represents a window of missed opportunity.

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The number of worsenings experienced by patients who had had ≥ 1 worsening in the last year, by level of Asthma Control Questionnaire-defined asthma control. A worsening was defined as an occasion when asthma symptoms had become bothersome or hindering in the past year. The mean number of worsenings for the total population was 11.8/year.
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Figure 2: The number of worsenings experienced by patients who had had ≥ 1 worsening in the last year, by level of Asthma Control Questionnaire-defined asthma control. A worsening was defined as an occasion when asthma symptoms had become bothersome or hindering in the past year. The mean number of worsenings for the total population was 11.8/year.

Mentions: Most patients (n = 3047 [89%]) experienced periods of worsenings during the last year (mean 11.8/year) (Figure 2). Even patients with well-controlled asthma reported an average of 6.3 worsenings/year. Overall, 42% of patients rated their most recent worsening as severe, 45% rated it as moderate and 13% as mild. On average, patients reported that 27% of the worsenings that they had experienced in the last year were severe.


Attitudes and actions of asthma patients on regular maintenance therapy: the INSPIRE study.

Partridge MR, van der Molen T, Myrseth SE, Busse WW - BMC Pulm Med (2006)

The number of worsenings experienced by patients who had had ≥ 1 worsening in the last year, by level of Asthma Control Questionnaire-defined asthma control. A worsening was defined as an occasion when asthma symptoms had become bothersome or hindering in the past year. The mean number of worsenings for the total population was 11.8/year.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC1483837&req=5

Figure 2: The number of worsenings experienced by patients who had had ≥ 1 worsening in the last year, by level of Asthma Control Questionnaire-defined asthma control. A worsening was defined as an occasion when asthma symptoms had become bothersome or hindering in the past year. The mean number of worsenings for the total population was 11.8/year.
Mentions: Most patients (n = 3047 [89%]) experienced periods of worsenings during the last year (mean 11.8/year) (Figure 2). Even patients with well-controlled asthma reported an average of 6.3 worsenings/year. Overall, 42% of patients rated their most recent worsening as severe, 45% rated it as moderate and 13% as mild. On average, patients reported that 27% of the worsenings that they had experienced in the last year were severe.

Bottom Line: The mean period from the onset to the peak symptoms of a worsening was 5.1 days.Although most patients recognised the early signs of worsenings, the most common response was to increase short-acting beta2-agonist use; inhaled corticosteroids were increased to a lesser extent at the peak of a worsening.However, they often adjust treatment in an inappropriate manner, which represents a window of missed opportunity.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Respiratory Medicine, Faculty of Medicine, Imperial College London, London, UK. m.partridge@imperial.ac.uk

ABSTRACT

Background: This study examined the attitudes and actions of 3415 physician-recruited adults aged > or = 16 years with asthma in eleven countries who were prescribed regular maintenance therapy with inhaled corticosteroids or inhaled corticosteroids plus long-acting beta2-agonists.

Methods: Structured interviews were conducted to assess medication use, asthma control, and patients' ability to recognise and self-manage worsening asthma.

Results: Despite being prescribed regular maintenance therapy, 74% of patients used short-acting beta2-agonists daily and 51% were classified by the Asthma Control Questionnaire as having uncontrolled asthma. Even patients with well-controlled asthma reported an average of 6 worsenings/year. The mean period from the onset to the peak symptoms of a worsening was 5.1 days. Although most patients recognised the early signs of worsenings, the most common response was to increase short-acting beta2-agonist use; inhaled corticosteroids were increased to a lesser extent at the peak of a worsening.

Conclusion: Previous studies of this nature have also reported considerable patient morbidity, but in those studies approximately three-quarters of patients were not receiving regular maintenance therapy and not all had a physician-confirmed diagnosis of asthma. This study shows that patients with asthma receiving regular maintenance therapy still have high levels of inadequately controlled asthma. The study also shows that patients recognise deteriorating asthma control and adjust their medication during episodes of worsening. However, they often adjust treatment in an inappropriate manner, which represents a window of missed opportunity.

Show MeSH
Related in: MedlinePlus