Identifying Patient Attitudinal Clusters Associated with Asthma Control: The European REALISE Survey

J Allergy Clin Immunol Pract. May-Jun 2018;6(3):962-971. doi: 10.1016/j.jaip.2017.10.007. Epub 2017 Nov 20.


Background: Asthma is a highly heterogeneous disease that can be classified into different clinical phenotypes, and treatment may be tailored accordingly. However, factors beyond purely clinical traits, such as patient attitudes and behaviors, can also have a marked impact on treatment outcomes.

Objective: The objective of this study was to further analyze data from the REcognise Asthma and LInk to Symptoms and Experience (REALISE) Europe survey, to identify distinct patient groups sharing common attitudes toward asthma and its management.

Methods: Factor analysis of respondent data (N = 7,930) from the REALISE Europe survey consolidated the 34 attitudinal variables provided by the study population into a set of 8 summary factors. Cluster analyses were used to identify patient clusters that showed similar attitudes and behaviors toward each of the 8 summary factors.

Results: Five distinct patient clusters were identified and named according to the key characteristics comprising that cluster: "Confident and self-managing," "Confident and accepting of their asthma," "Confident but dependent on others," "Concerned but confident in their health care professional (HCP)," and "Not confident in themselves or their HCP." Clusters showed clear variability in attributes such as degree of confidence in managing their asthma, use of reliever and preventer medication, and level of asthma control.

Conclusions: The 5 patient clusters identified in this analysis displayed distinctly different personal attitudes that would require different approaches in the consultation room certainly for asthma but probably also for other chronic diseases.

Keywords: Asthma; Attitudes; Beliefs; Cluster; Control; Management; Patient.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Asthma / epidemiology
  • Asthma / psychology*
  • Attitude to Health*
  • Cluster Analysis
  • Europe / epidemiology
  • Factor Analysis, Statistical
  • Female
  • Humans
  • Male
  • Middle Aged
  • Perception
  • Surveys and Questionnaires
  • Treatment Outcome
  • Young Adult