New survey reveals patients and doctors need to talk about asthma management.
If you have asthma, ask your doctor to talk with you about how to properly manage and control your condition.
That was one of the most important messages from the Asthma Insight and Management (AIM), the largest, most comprehensive survey of asthma patients and physicians in the United States in a decade. Results of the survey of 2,500 current asthma patients 12 and older, 1,004 adults without asthma, and 309 physicians in the United States, were released in November 2009.
The study showcases the burden of this chronic disease, says Dr. Robert Nathan, an allergist at Asthma & Allergy Associates and Research Center in Colorado Springs and Pueblo, and a principal adviser on the survey.
What the survey found
Nearly half (47%) of the national sample of patients with asthma were classified in the AIM survey as having very poorly controlled asthma, based on asthma management guidelines. In the past year, one in three was hospitalized, visited emergency rooms, or had other unscheduled health care visits due to asthma. At that rate, the survey estimated, more than one million patients were hospitalized and nearly three million visited emergency rooms as a result of worsening asthma.
The AIM study provided a benchmark on progress in asthma care since the last landmark asthma survey, Asthma in America (AIA), in 1998. AIM revealed that there have been no improvements in hospitalizations or other unscheduled emergency visits for asthma over the past decade. The percentage of adults with asthma who were hospitalized due to asthma, 7%, was the same in 2009 as in 1998, and slightly more patients reported other unscheduled emergency visits due to asthma in 2009 (26%) than in 1998 (25%).
- One in five asthma patients said they lived in fear of hospitalizations or emergency room visits due to asthma, and 29% of patients said that fear of making their asthma worse keeps them from doing the things they want.
- Twelve percent of asthma patients who had an episode that was more frequent or severe than normal reported that these episodes lasted between seven and 13 days, while 18% reported that these episodes lasted three to four days. The mean duration of these episodes was 6.5 days.
- Asthma patients reported a 33 percent decline in average productivity at times of the year when asthma was at its worst, compared with a typical day.
- Adult asthma patients reported taking an average of 12.4 sick days, compared with 3.6 sick days for adults without asthma in the past year; and 37.9 days in which they limited their activities, compared with 15.8 days for adults without asthma in the past year.
- Twenty-eight percent of adult asthma patients say they feel “a lot” of or “some” limitations in social activities due to their asthma, compared with 14% of adults without asthma.
- Despite the availability of medications to control asthma, 9% of patients use 12 or more rescue inhalers throughout the year.
“Asthma guidelines stress that the use of rescue medication should be less than three times a week, or no more than one or two inhalers per year,” Dr. Nathan says. “A lot of people are going through many more.”
The AIM survey also showed that patients frequently discontinue their maintenance medications: 11% said they stopped taking their maintenance medications for one to two weeks; 18% for three weeks to five months; and 9% for six months or longer.
Living with a chronic condition
Asthma patients should understand that, even though they do not have symptoms all the time, asthma is a chronic condition that requires the consistent use of medications. If you have questions about your asthma or it is worsening, talk to your physician.
When asked if their asthma is controlled, patients often say yes, when in fact their asthma is impacting their lives far more than it should. The majority of asthma patients surveyed considered their asthma well managed, even when worsening symptoms required frequent urgent doctor visits.
If you are having episodes requiring more than two urgent care visits or more than one ER visit in a year, this should alert your physician to get a specialist involved, Dr. Nathan says.
Dr. Nathan is the author of the Asthma Control Test, which was developed to help physicians evaluate their asthma patients’ control using a brief, five-question questionnaire. He recommends that asthma patients take such a test every time they see their doctor, even if asthma isn’t the reason for the office visit.
Patients in the survey also said they didn’t always understand the terms their doctor used when discussing their asthma.
Make sure your physician talks to you about your asthma in language that you can understand; discuss with your doctor what well-controlled and well-managed asthma means; and understand that taking your medications consistently is crucial to control.
For more detailed information about the AIM survey and its findings, visit http://www.TakingAIMatAsthma.com.