Asthma Management

Education

The Global Asthma Physician and Patient survey reveals unmet needs

The GAPP survey involving more than 5000 physicians, adult patients with asthma, and parents of children with asthma from 16 nations worldwide identified a discrepancy between physician and patient perceptions about communication and education relating to asthma (Table 1). The lack of physician–patient communication was found to be a critical factor impeding proper medication use and effective asthma management.

Table 1. Education, side effects and compliance1
What patients said:What physicians said:
Incidence of patients reporting compliance with
treatment:
  • 0% of the time: 4%
  • 1–50% of the time: 22%
  • 51–81% of the time: 14%
  • 81–99% of the time: 12%
  • 100% of the time: 48%
Patient’s compliance as reported by physicians:
  • 0% of the time: 0%
  • 1–50% of the time: 31%
  • 51–81% of the time: 55%
  • 81–99% of the time: 9%
  • 100% of the time: 5%
Patients frequently cited their side effects as a reason
for non-compliance:
  • 21% and 18% of patients were non-compliant or
    switched medication because they experienced
    side effects or were concerned about side effects,
    respectively
  • 21% of patients who did experience side effects
    were non-compliant
 
60% of patients believed that they initiated discussions
about side effects with their physician
76% of physicians state that they initiate the
side-effect conversation
Approximately one-half of patients report never
discussing short- or long-term side effects with their
physicians
92% of physicians said that they sometimes or always
discuss short-term side effects, and 66% said that they
sometimes or always discuss long-term side effects
69% of patients said that they received inhaler
instructions from their doctor
95% of physicians said they regularly instruct patients
on how to use their inhaler correctly
Over half (54%) of patients did not know or believe
that mild asthma could be fatal
 

Both patients and physicians agreed that better physician–patient communications and improved patient education are needed. It was also noted that available therapies are less than ideal and that better medications are needed.1 In fact, 81% of physicians believe improvement with ICS therapy is needed, and said they would prescribe a new medication if the side-effect profile were improved.1 Such a medication should incorporate all of the following characteristics:

  1. Selectivity to the target site (i.e. the lungs)
  2. Activation at the target site
  3. Prolonged activity at the target site (to provide enhanced anti-inflammatory activity)
  4. Decreased potential for local and systemic side effects
  5. Once-daily dosing

References:
1. Global asthma physician and patient (GAPP) survey www.gappsurvey.org. 2006.

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