June 15, 2007 / 10:57 PM / in 11 years

Most asthma patients have uncontrolled disease

NEW YORK (Reuters Health) - In a recent U.S. survey of asthma patients, more than half reported that their disease is uncontrolled and that they have never received an asthma action plan, according to a report in the Journal of Allergy and Clinical Immunology.

The emphasis of a new draft of U.S. asthma guidelines is better physician and patient education, with a focus on asthma control at each asthma clinic visit, Dr. Stephen P. Peters from Wake Forest University School of Medicine, Winston-Salem, North Carolina told Reuters Health. In this effort, physicians need “to partner with patients.”

Peters and associates in the Real-World Evaluation of Asthma Control and Treatment (REACT) study assessed the prevalence of uncontrolled asthma in a nationally representative sample of patients with moderate-to-severe asthma receiving standard asthma medications.

More than half the 1,812 respondents (55 percent) had uncontrolled asthma, the authors report.

Only 34.9 percent of patients with uncontrolled asthma and 26.4 percent of patients with controlled asthma had ever received a personalized asthma action plan from a physician, the results indicate.

About half the patients with uncontrolled asthma and 60 percent of patients with controlled asthma were taking an inhaled corticosteroid and long-acting beta-agonist, the researchers note. More than half the patients with uncontrolled asthma and nearly 30 percent of patients with controlled asthma reported taking their asthma medications more often than prescribed.

Younger age, Hispanic race, male sex, lower income, and lower education level were independently associated with an increased risk of uncontrolled disease, as were chronic sinusitis, high blood pressure, and gastroesophageal reflux disease, also referred to as “GERD.”

“The REACT study shows that even with access to health care, patients prescribed therapy that is recommended for moderate-to-severe asthma still demonstrate high rates of uncontrolled asthma,” the authors conclude.

These survey results “highlight the critical need” to conduct a more thorough evaluation of asthma control, implement asthma treatment plans, and treat co-existing conditions to improve asthma care in patients with moderate-to-severe asthma.

“We are now exploring attitudes associated with poor asthma control and trying to develop a ‘REACT asthma attitude score,'” Peters added.

SOURCE: Journal of Allergy and Clinical Immunology, June 2007.

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