Patient perspectives of the influence of severe and non‐severe asthma on their quality of life: A national survey of asthma patients in Spain

Abstract

Introduction: Little is known about adult asthma patients' perspective of their disease burden. This study aimed to obtain a comprehensive picture of patient needs, evaluate their knowledge, source of information, and perception of the severity of their asthma, and compare these variables between severe (SA) and non-severe (NSA) asthma patients. Methods: We conducted an online cross-sectional survey in Spain among asthma patients aged ≥18 years. A bespoke questionnaire was used to collect sociodemographic data, asthma characteristics, treatments, disease burden, patient's perception of disease severity, and asthma information sources. Patients were classified as SA and NSA according to GINA 2020 treatment steps recommendations. To compare populations, 600 participants (200 SA and 400 NSA) were randomly selected to complete the survey. Results: Participants were mostly women, mean age >38 years. SA patients underestimated the severity of their asthma; 52% judged it as mild, and only 2% considered their asthma severe. Overall, 50% of NSA and 96% of SA patients had experienced ≥1 exacerbation the previous year (p < 0.001). Fewer asthma exacerbations (SA) and improved quality of life (QoL) (NSA) were the most frequently expected therapy outcomes. NSA patients believe that asthma impacts their daily life (37%) and worsens QoL (34%) to a lesser degree than SA (67% and 59%, respectively; p < 0.001). Patient-preferred sources of information were specialists (NSA:42%; SA: 38%) and primary care physicians (NSA: 41%; SA: 33%).Conclusions: Despite the effective therapies currently available, the results of this study still show a significant emotional burden and QoL impairment in patients with severe asthma.

Characteristics of Oral Corticosteroid Users Among Persons with Asthma on GINA Step 3 Therapy and Above: A Cross-Sectional Study in Portuguese Community Pharmacies

“…Three out of ten patients reported not having used any healthcare resource in the year prior to the study, and a considerable proportion of patients (40.8%) did not attend to any routine medical appointment in the same period, which goes against the asthma management recommendations that advocate each patient should have an asthma review at least once a year. 27 Unscheduled medical appointments, [28][29][30] Emergency Department visits (particularly among non-OCS users), 28,30,31 and hospitalizations 29,30,32 were also less frequent than reported by other studies. In fact, only 18% of the participants visited the ED due to asthma in the previous year, a lower proportion than that reported by step 3+ patients using a short-acting beta agonist (SABA) inhaler (45%) in a previous study conducted in Portugal.…”

Analysis of Patients Admitted for Asthma Exacerbation in a Tertiary Hospital in Spain

“…In our series, instances of poor adherence to GEMA guidelines and low compliance with TAI are significant factors in the exacerbation of asthma. Both patients with severe and non-severe asthma tend to underestimate the severity of their condition, which is a key factor in the development of exacerbations [ 23 ].…”

Mild asthma: Conundrums, complexities and the need to customize care

“…It is clear from studies exploring patient perspectives in detail, that 'mild' as a term to describe asthma is misunderstood by patients and may be associated with frequent symptoms and exacerbations, oral steroid use and poor quality of life. 22,48 This mis-perception of asthma severity constitutes a risk in its own right. It is therefore worth considering whether we should drop the severity terms, mild, moderate and severe, acknowledging their limited usefulness, imprecision and inaccuracy and simply aim to make a diagnosis of asthma objectively, assess symptom burden and risk, and treat using these features in the context of also assessing TTs.…”

“…Almost three‐quarters of the patients took their medications intermittently and half of these acknowledged only when they had symptoms. It is clear from studies exploring patient perspectives in detail, that ‘mild’ as a term to describe asthma is misunderstood by patients and may be associated with frequent symptoms and exacerbations, oral steroid use and poor quality of life 22,48 . This mis‐perception of asthma severity constitutes a risk in its own right.…”