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Abstract
Uncontrolled asthma is a major health problem. Personal perceptions of asthma control often vary between patients and their treating physicians, and both may differ from actual control. This can be a major barrier in optimising patient asthma care.
The aim of this cross-sectional survey was to provide UK-specific data on actual and perceived asthma control in a sample of adult (18–75 years) asthma patients attending routine asthma reviews in primary, secondary and tertiary settings. Differences between healthcare professionals’ (HCP) and patients’ perceived assessments of asthma control were evaluated via an online questionnaire and compared to a control – the validated Asthma Control Test (ACT) questionnaire, which was completed by the patient.
Patients with a documented diagnosis of asthma who were taking medication (at least a short acting ß-agonist) were enrolled and consented by their HCP within a month of their last clinic appointment. Individuals with a history of an asthma exacerbation within prior 4 weeks; a diagnosis of another respiratory condition; or a smoking history >10 pack years were excluded. Patients were grouped into BTS/SIGN treatment Steps 1–5.
260 patients were screened. 234 patients were eligible for the study: 33, 52, 50, 49 and 50 patients in Steps 1 to 5, respectively. Women composed 70% (164) of the study population. 47.4% of patients were aged 45–64 years. 164 patients (70%) were classed as non-smokers by HCPs.
The ACT results suggest that asthma was only controlled in 54.7% of patients overall (defined as ACT score ≥20), with levels of uncontrolled asthma highest in Step 4–5 patients. This is in contrast to 84.2% of patients and 73.9% of HCPs who perceived that asthma was controlled.
Perception of asthma control did not correlate with ACT score: Patients vs HCPs
These data suggest a high level of uncontrolled asthma in UK asthma patients, especially Step 4–5 patients. A significant proportion of both patients and HCPs may have an incorrect perception of asthma control, representing a significant unmet medical need in terms of optimal asthma management.
Overall, correct correlation of ACT score with perception of controlled or uncontrolled asthma only occurred in 67.9% of patients and 68.8% of HCPs. The poorest correlations occurred in Step 4–5 patients.