Asthma patients' and physicians’ perspectives on the burden and management of asthma - 21/09/21
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Abstract |
Background |
The 2021 Global Initiative for Asthma (GINA) report recommends as-needed inhaled corticosteroid (ICS)/formoterol irrespective of severity, and maintenance and reliever treatment (MART) from GINA Step 3 as part of Treatment Track 1, partly based on the SYGMA studies. We investigated how current clinical practice in Australia, Canada, China and the Philippines relates to latest GINA recommendations.
Methods |
Patients and physicians were recruited from online panels between July and August 2020 and invited to complete an online survey. Inclusion criteria: age ≥18 years, current/past physician diagnosis of asthma (patients); primary care (Canada also included respirologists/respiratory therapists), treating ≥4 patients with asthma per month, ≥3 years in clinical practice (physicians).
Results |
Overall, 1216/70,183 patients and 803/8376 physicians replied and were eligible for inclusion. Only 8–15% of patients were using MART; 66–81% used regular maintenance therapy with/without an as-needed reliever. Across the four countries, physicians classified 48–63% of their patients as mild (GINA Steps 1–2) and 28–36% as moderate (GINA Steps 3–4). Generally, physicians rated symptom control over exacerbation reduction as their main treatment goal; patients also ranked symptom relief as very important. Approximately 9–29% of patients and 24–45% of physicians were unaware of MART, and among those who prescribed MART, 80–95% prescribed an additional (non-ICS) as-needed reliever.
Interpretation |
Most physicians prioritized managing asthma symptoms over exacerbations. A lack of awareness and understanding of MART dosing exists among physicians. Practical strategies are required to implement GINA recommendations effectively in real-world clinical practice and to identify appropriate patients for MART.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Most physicians prioritize symptom control over reducing exacerbations. |
• | Patients also consider symptom relief to be very important. |
• | Physicians classified a substantial proportion of patients as GINA Step 3 or higher. |
• | A large number of physicians and patients were not aware of MART. |
• | Most physicians had prescribed an additional as-needed reliver alongside MART. |
Keywords : Asthma symptoms, Global cohort, Patient perspectives, Physician perspectives, Guideline adherence, GINA
Abbreviations : ANOVA, ICS, GINA, LABA, MART, PRN, SABA, SD, SYGMA
Plan
All authors contributed equally to this work. |
Vol 186
Article 106524- septembre 2021 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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