Asthma control: do patients' and physicians' opinions fit in with patients' asthma control status?

J Asthma. Jul-Aug 2007;44(6):461-7. doi: 10.1080/02770900701421989.

Abstract

The aim of this study was to determine the level of asthma control and the concordance between physicians' and patients' opinions and the real patients' situation. A total of 777 subjects (55% female) with asthma were recruited. The study comprised a 4-week follow-up period, during which subjects completed a diary recording peak expiratory flow (PEF), symptoms, and use of rescue medication. At the end, both physicians and patients rated asthma control status. The level of control was evaluated using a composite measure. Agreement among subjective assessments of asthma control by patients and physicians and objective evaluation with the composite measure was assessed through kappa scores. A total of 518 (67%) patients had "not well-controlled asthma," being the remaining "totally controlled" (8%) or "well-controlled" (25%). "Not well-controlled asthma" was more frequent in smokers (82%) than in ex-smokers (70%) or in non-smokers (62%; p=0.0002). Kappa scores between patients' and physicians' opinions and the real patients' status were 0.02 (95% CI, 0.01-0.05) and 0.07 (95% CI, 0.03-0.09), respectively. In conclusion, current level of asthma control is suboptimal for a majority (67%) of patients in Spain. Besides, asthma control is worse in smokers. Neither patients' nor physicians' opinions agree with patients' real situation. Both patients and physicians accept as normal a suboptimal status of their disease.

Publication types

  • Clinical Trial
  • Multicenter Study

MeSH terms

  • Adrenergic beta-Agonists / therapeutic use*
  • Adult
  • Asthma / drug therapy*
  • Asthma / physiopathology
  • Attitude of Health Personnel
  • Child
  • Cross-Sectional Studies
  • Female
  • Follow-Up Studies
  • Guideline Adherence / statistics & numerical data
  • Humans
  • Male
  • Medical Records
  • Middle Aged
  • Patient Satisfaction / statistics & numerical data
  • Peak Expiratory Flow Rate / drug effects
  • Physicians / psychology
  • Physicians / statistics & numerical data
  • Spain
  • Time Factors
  • Treatment Outcome

Substances

  • Adrenergic beta-Agonists