The Living & Breathing Study: a study of patients' views of asthma and its treatment

Prim Care Respir J. 2004 Mar;13(1):28-35. doi: 10.1016/j.pcrj.2003.11.007.

Abstract

Aim: To evaluate patient understanding of their asthma and determine patient preferences regarding the delivery of asthma care and treatment.

Methods: Adults with asthma receiving treatment for mild to moderate asthma were recruited to a two-part study: a qualitative phase using a semi-structured interview schedule followed by a quantitative phase based on a structured interview schedule. All interviews were undertaken face-to-face.

Setting and subjects: A random sample of 40 patients with mild to moderate asthma from seven areas of the UK took part in the qualitative phase of the study. In the quantitative phase, 517 patients on treatment for mild to moderate asthma were interviewed in person by market researchers. This population was achieved using a quota sampling approach that also achieved a representative demographic profile. Initial contact was made in door-to-door calls. Interviews took place in 64 locations across the UK.

Results: Ninety-one percent (n=468) of respondents felt their asthma was under control, yet two-thirds (n=339) experienced symptoms at least 2-3 times a week. Only 24% (n=123) felt their asthma could improve over time, and 71% (n=366) received no advice from healthcare professionals on how their asthma might change in the future. Fourteen percent (n=74) of respondents had no ongoing contact with any healthcare professional regarding their asthma. Fifty-eight percent (n=301) were very satisfied with their asthma care, but this dropped to 33% (n=173) when respondents were shown asthma guidelines regarding what to expect from treatment. Sixty-two percent (n=318) of respondents said their asthma varied at different times of the day, and 86% (n=444) stated that their asthma varied at different times of the year. Eighty percent (n=414) of respondents had never been provided with a written, personal asthma action plan recommending changes patients could make themselves to prescribed treatment according to symptom severity, though 68% (n=353) said they would feel comfortable following such a plan.

Conclusions: Most patients have low expectations of what can be achieved by asthma management and do not realise their condition can be improved. Many are resigned to the effects of poor asthma control until made aware that guidelines indicate this can be better. Given that many are receptive to the notion of written, personal asthma action plans, the implementation of these, supported by appropriate education, could help patients achieve improved asthma control.