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A multinational observational study identifying primary care patients at risk of overestimation of asthma control.
NPJ Prim Care Respir Med 2019; 29(1):43NP

Abstract

Factors related to the discrepancy between patient-perceived and actual disease control remain unclear. Identifying patients at risk of overestimation of asthma control remains elusive. This study aimed to (i) investigate the relationship between patient-reported and actual level of asthma control (ii), compare the characteristics between patients who believe their asthma is well controlled that accurately report 'well-controlled' asthma with those that do not, and (iii) identify factors associated with inaccurately reported 'well-controlled' asthma. A historical, multinational, cross-sectional study using data from the iHARP (initiative Helping Asthma in Real-life Patients) review service for adults with asthma prescribed fixed-dose combination therapy. Data from 4274 patients were analysed. A major discrepancy between patient-reported and Global Initiative for Asthma defined asthma control was detected; 71.1% of patients who reported 'well-controlled' asthma were inaccurate in their perception despite receiving regular maintenance therapy. Significant differences were noted in age, gender, body mass index, education level, medication use, side effects, attitudes to preventer inhaler use, inhaler technique review and respiratory specialist review between patients who accurately reported 'well-controlled' asthma and those who did not. Independent risk factors associated with inaccurately reported 'well-controlled' asthma were: having taken a maximum of 5-12 puffs or more of reliever inhaler on at least one day within the previous 4 weeks; being female; having seen a respiratory specialist more than a year ago (rather than in the previous year); and having required oral corticosteroids for worsening asthma in the previous year. The study highlighted the significant hidden burden associated with under-recognition of poor asthma control, on the part of the patient and the need for targeted interventions designed to address the continuing discrepancy between perceived and actual disease control.

Authors+Show Affiliations

Quality Use of Respiratory Medicines Group, Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW, Australia. vicky.kritikos@sydney.edu.au. Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Sydney, NSW, Australia. vicky.kritikos@sydney.edu.au.Optimum Patient Care, Cambridge, UK. Observational and Pragmatic Research Institute, Southbank, Singapore. Academic Primary Care, University of Aberdeen, Aberdeen, UK.Respiratory Medicine, University of Ferrara, Ferrara, Italy.Special Interest Respiratory Area, Italian Interdisciplinary Society for Primary Care, Bari, Italy.Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine, Uppsala University, Uppsala, Sweden.Optimum Patient Care, Cambridge, UK. Allergy and Respiratory Research Group, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK.Department Experimental and Clinical Medicine, University of Florence, Firenze, Italy.Inhalation Consultancy Ltd, Leeds, UK.NHS Greater Glasgow & Clyde R&D, Glasgow, UK.Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine, Uppsala University, Uppsala, Sweden.Box Surgery, Box, UK.Primary Care Respiratory Research Unit, Instituto de Investigación Sanitaria de Baleares (IdISBa), Palma, Spain.Department of Primary Health Care Services, Norwegian Directorate of Health, Oslo, Norway.Department of Primary Care, University of Groningen, University Medical Centre Groningen, Groningen, Netherlands.Optimum Patient Care, Cambridge, UK. Observational and Pragmatic Research Institute, Southbank, Singapore.Quality Use of Respiratory Medicines Group, Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW, Australia. Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia. Central Sydney Local Area Health District, Sydney, NSW, Australia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31804501

Citation

Kritikos, Vicky, et al. "A Multinational Observational Study Identifying Primary Care Patients at Risk of Overestimation of Asthma Control." NPJ Primary Care Respiratory Medicine, vol. 29, no. 1, 2019, p. 43.
Kritikos V, Price D, Papi A, et al. A multinational observational study identifying primary care patients at risk of overestimation of asthma control. NPJ Prim Care Respir Med. 2019;29(1):43.
Kritikos, V., Price, D., Papi, A., Infantino, A., Ställberg, B., Ryan, D., ... Bosnic-Anticevich, S. (2019). A multinational observational study identifying primary care patients at risk of overestimation of asthma control. NPJ Primary Care Respiratory Medicine, 29(1), p. 43. doi:10.1038/s41533-019-0156-4.
Kritikos V, et al. A Multinational Observational Study Identifying Primary Care Patients at Risk of Overestimation of Asthma Control. NPJ Prim Care Respir Med. 2019 Dec 5;29(1):43. PubMed PMID: 31804501.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A multinational observational study identifying primary care patients at risk of overestimation of asthma control. AU - Kritikos,Vicky, AU - Price,David, AU - Papi,Alberto, AU - Infantino,Antonio, AU - Ställberg,Bjorn, AU - Ryan,Dermot, AU - Lavorini,Federico, AU - Chrystyn,Henry, AU - Haughney,John, AU - Lisspers,Karin, AU - Gruffydd-Jones,Kevin, AU - Román Rodríguez,Miguel, AU - Høegh Henrichsen,Svein, AU - van der Molen,Thys, AU - Carter,Victoria, AU - Bosnic-Anticevich,Sinthia, Y1 - 2019/12/05/ PY - 2019/05/22/received PY - 2019/11/08/accepted PY - 2019/12/6/entrez PY - 2019/12/6/pubmed PY - 2019/12/6/medline SP - 43 EP - 43 JF - NPJ primary care respiratory medicine JO - NPJ Prim Care Respir Med VL - 29 IS - 1 N2 - Factors related to the discrepancy between patient-perceived and actual disease control remain unclear. Identifying patients at risk of overestimation of asthma control remains elusive. This study aimed to (i) investigate the relationship between patient-reported and actual level of asthma control (ii), compare the characteristics between patients who believe their asthma is well controlled that accurately report 'well-controlled' asthma with those that do not, and (iii) identify factors associated with inaccurately reported 'well-controlled' asthma. A historical, multinational, cross-sectional study using data from the iHARP (initiative Helping Asthma in Real-life Patients) review service for adults with asthma prescribed fixed-dose combination therapy. Data from 4274 patients were analysed. A major discrepancy between patient-reported and Global Initiative for Asthma defined asthma control was detected; 71.1% of patients who reported 'well-controlled' asthma were inaccurate in their perception despite receiving regular maintenance therapy. Significant differences were noted in age, gender, body mass index, education level, medication use, side effects, attitudes to preventer inhaler use, inhaler technique review and respiratory specialist review between patients who accurately reported 'well-controlled' asthma and those who did not. Independent risk factors associated with inaccurately reported 'well-controlled' asthma were: having taken a maximum of 5-12 puffs or more of reliever inhaler on at least one day within the previous 4 weeks; being female; having seen a respiratory specialist more than a year ago (rather than in the previous year); and having required oral corticosteroids for worsening asthma in the previous year. The study highlighted the significant hidden burden associated with under-recognition of poor asthma control, on the part of the patient and the need for targeted interventions designed to address the continuing discrepancy between perceived and actual disease control. SN - 2055-1010 UR - https://www.unboundmedicine.com/medline/citation/31804501/A_multinational_observational_study_identifying_primary_care_patients_at_risk_of_overestimation_of_asthma_control L2 - http://dx.doi.org/10.1038/s41533-019-0156-4 DB - PRIME DP - Unbound Medicine ER -