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A multinational observational study identifying primary care patients at risk of overestimation of asthma control
Univ Sydney, Woolcock Inst Med Res, Qual Use Resp Med Grp, Sydney, NSW, Australia;Royal Prince Alfred Hosp, Dept Resp & Sleep Med, Sydney, NSW, Australia.
Optimum Patient Care, Cambridge, England;Southbank, Observat & Pragmat Res Inst, Singapore, Singapore;Univ Aberdeen, Acad Primary Care, Aberdeen, Scotland.ORCID iD: 0000-0002-9728-9992
Univ Ferrara, Resp Med, Ferrara, Italy.
Italian Interdisciplinary Soc Primary Care, Special Interest Resp Area, Bari, Italy.
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2019 (English)In: NPD Bulletin, ISSN 1892-8110, E-ISSN 2055-1010, Vol. 29, article id 43Article in journal (Refereed) Published
Abstract [en]

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 'wellcontrolled' 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.

Place, publisher, year, edition, pages
NATURE PUBLISHING GROUP , 2019. Vol. 29, article id 43
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Respiratory Medicine and Allergy
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URN: urn:nbn:se:uu:diva-401183DOI: 10.1038/s41533-019-0156-4ISI: 000502995200001PubMedID: 31804501OAI: oai:DiVA.org:uu-401183DiVA, id: diva2:1383085
Available from: 2020-01-07 Created: 2020-01-07 Last updated: 2020-01-07Bibliographically approved

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