[Bronchial asthma: a comparison of the doctor's assessment and the patient's opinion].
OBJECTIVE
The aim of this enquiry was to compare the doctor's attitude with the patient's opinion on asthma treatment, in order to reveal gaps in each other's relationship, which could be the basis of designing a better information strategy and improve disease management.


METHODS
General practitioners (n = 202) and Internists (n = 103) in private practice, as well as asthma patients (n = 244) were asked to take part in telephone interviews regarding their treatment beliefs. To accomplish this, a structured questionnaire was used by an experienced interviewer. 50 % of the patients were treated with steroids.


RESULTS
Over 90 % of the patients were treated with short- and long acting beta (2)-agonists (alone or in combination). Up to 20% more patients reported suffering from cough, bronchitis, hay fever, and sinusitis than the physician's estimated. Although treated patients reported frequent cough episodes and wheezing. 42 % of all patients (in contrast to 52 % according to their physician had estimated) "side effects" and 21 % (46 % estimated by physicians) named "frequency of application" as their major concern. Patients preferred the oral application form (tablet, capsule) to the same extent as metered dose inhalers (40 % positive answers). Physicians overestimated the preference of the oral application form (62 % positive answers).


CONCLUSIONS
Our inquiry revealed high incidence of typical asthma symptoms despite therapeutic interventions, and a disparity of the physician's assessment of their patient's aversions and preferences of asthma medication and the mode of application. This investigation may help to improve the patient-physician relationship by contributing to a better understanding of patients' individual attitudes, and eventually leading to better asthma control.
Robert Koch-Klinik, Klinikum St. Georg, Leipzig. adrian.gillissen@sanktgeorg.de
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Gillissen
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Lecheler
D000280:Administration, Inhalation; D000284:Administration, Oral; D000318:Adrenergic beta-Agonists / Q000008:administration & dosage / Q000009:adverse effects; D000328:Adult; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000009:adverse effects; D001249:Asthma / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology*; D003142:Communication; D004359:Drug Therapy, Combination; D005260:Female; D005858:Germany; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D007388:Internal Medicine; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011320:Primary Health Care; D012803:Sick Role; D016896:Treatment Outcome
D000318:Adrenergic beta-Agonists; D018927:Anti-Asthmatic Agents; D005938:Glucocorticoids