title: Understanding how asthmatics perceive symptom distress during a methacholine challenge.
abstract: The way, or ways, in which asthmatics recognize specific symptom(s) with varying degrees of their airway obstruction, or asthma severity, is poorly understood. Our purpose was to gain a better understanding of how asthma patients during acute episodes, based on their symptom perception, decide when to seek symptom relief. A cross-sectional design was used to study 32, 16 per group, African Americans and Caucasians with a mean age of 34.5 years. All had mild, stable asthma (FEV1 > or = 70%), were non-smokers, atopic, and had not used inhaled or oral steroids for 3 months. Their mean baseline FEV1 was 97.5% predicted; all were controlled with intermittent use of a beta agonist inhaler. All had a bronchoconstrictor challenge using a provocative concentration of methacholine to achieve a 30% fall (PC30) in their FEV1. After achieving a PC30 and before their first dose of a bronchodilator was given, all subjects were asked: "If you felt this way at home would you take your inhaler?" Subjects were blinded to the fact that the yes/no question was asked when their FEV1 was reduced by 30%. In both groups, 44% responded "no" that they would not use their inhaler at that point in time. This finding suggests that those subjects, the 44% who failed to associate a change in their symptoms with increased airflow obstruction, may be at risk for life-threatening episodes.
authors.affiliation: Department of Nursing, The University of California at San Francisco, USA. ghardie@itsa.ucsf.edu
authors.forename: Grace E
authors.initials: GE
authors.lastname: Hardie
authors.forename: Warren M
authors.initials: WM
authors.lastname: Gold
authors.forename: Susan
authors.initials: S
authors.lastname: Janson
authors.forename: Virginia
authors.initials: V
authors.lastname: Carrieri-Kohlman
authors.forename: Homer A
authors.initials: HA
authors.lastname: Boushey
mesh_terms: D000328:Adult; D001249:Asthma / Q000503:physiopathology / Q000523:psychology*; D016085:Bronchoconstrictor Agents; D003430:Cross-Sectional Studies; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D016210:Methacholine Chloride; D010465:Perception
chemical_list: D016085:Bronchoconstrictor Agents; D016210:Methacholine Chloride