Respiratory medicine
How well controlled is asthma in people on daily inhalers?
Open access · cc by · source: Europe PMC
Most people taking daily preventer inhalers still had poorly controlled asthma, and when symptoms worsened they reached for their rescue inhaler first and increased their preventer only late.
Study at a glance
- Design
- Cross-sectional — Multinational telephone survey using a structured questionnaire and the Asthma Control Questionnaire; patients recruited through their primary-care physicians and specialists.
- N
- N=3415 · 3,415 patients completed full interviews out of 3,893 enrolled, across 11 countries.
- Population
- Adults and adolescents aged 16 or older with physician-diagnosed asthma prescribed daily inhaled corticosteroid maintenance therapy, with or without a long-acting β2-agonist, in Europe, North America and Australia.
- Outcome
- Asthma control (ACQ score), frequency of worsenings, unscheduled medical care, how patients adjusted medication during worsenings, and attitudes to self-management.
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Key findings
By questionnaire score, only 28% had well-controlled asthma and 51% were uncontrolled, yet most patients with uncontrolled asthma still described their control as relatively good. In the week before the interview, 74% used their rescue inhaler every day, 51% had needed unplanned medical care in the past year, and 89% reported worsenings, averaging about 12 a year. During worsenings patients increased their rescue (short-acting β2-agonist) inhaler first and raised their inhaled steroid only later and less, even though 52% said they stepped up their maintenance dose on their own. Most patients felt confident self-managing and preferred adjusting their medication to how their asthma felt.
Methodology
Physicians in 11 countries asked consecutive adult asthma patients on regular inhaled corticosteroids (alone or combined with a long-acting bronchodilator) to take part in a 30-minute structured telephone interview. Patients reported their medication use, worsenings and unplanned medical care over the past year, their own view of their control, and their attitudes to managing asthma. Control was also scored with a validated tool, the Asthma Control Questionnaire.
Limitations
All data are self-reported by telephone, so medication use, worsenings and hospital visits could be misremembered, and there is no objective lung-function measurement. Patients were recruited through recent clinic visits, which may exclude people with poor access to care and may over-represent more severe disease; some may have had undiagnosed COPD. As a one-off survey, it describes behaviour but cannot show that adjusting inhaled steroids earlier would improve control. The study was sponsored with involvement from a drug manufacturer and conducted by a market-research agency.
How this study connects
Role on claims
Each row is a claim on a concept or method page where this paper supports, challenges, or qualifies the statement. Roles are hand-checked — not a model guess.
Being on a preventer inhaler does not mean asthma is controlled, and patients underestimate poor control.
In a telephone survey of 3,415 patients in 11 countries on daily inhaled corticosteroids, only 28% had well-controlled asthma by questionnaire score and 74% had used their rescue inhaler every day in the past week, yet most with uncontrolled asthma rated their control as fairly good.
Evidence for the claim as stated.
Being on a preventer inhaler does not mean asthma is controlled, and patients underestimate poor control.
In a telephone survey of 3,415 patients in 11 countries on daily inhaled corticosteroids, only 28% had well-controlled asthma by questionnaire score and 74% had used their rescue inhaler every day in the past week, yet most with uncontrolled asthma rated their control as fairly good.
Scope note — Self-reported, cross-sectional, no lung-function measurement; industry-sponsored.
Limits the claim's scope: a different population, assay, or outcome.
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