Do the British Guidelines for Asthma Management facilitate concordance?
BACKGROUND
Asthma is an example of a common, chronic illness in which clinicians are encouraged to promote concordance and adhere to guidelines. Some existing research suggests that these aims may be incompatible.


OBJECTIVE
To describe patient goals for life and for asthma management in order to inform concordance with people with asthma.


METHODS
A cross-sectional, qualitative survey.


METHODS
A purposive sample of 47 adults with asthma from Dundee, UK. The subjects were identified from general practice asthma registers and had a range of ages and asthma severity but no significant comorbidity.


METHODS
Tape-recorded semi-structured interviews. The topic guide was based on the literature and had been piloted in a previous study.


RESULTS
The participants focussed on improving their lives, only aiming to improve their asthma as a means of improving their lives. Three aspects of asthma were reported to help or hinder improving life: the use of asthma medication, trigger avoidance and exercise. People integrated these three aspects of asthma in order to maximize life.


CONCLUSIONS
The study supports the more individualized goals of the recently revised British Guidelines for Asthma Management but highlights the need to develop this further in future revisions. It also provides an explanation for patients' acceptance of less than 'perfect' asthma control and it suggests that shared goals may be achieved in practice by considering the advantages and disadvantages of medication and allergen avoidance on everyday life rather than on asthma.
Tayside Centre for General Practice, University of Dundee, Dundee, UK. k.steven@dundee.ac.uk
Karen
K
Steven
Wendy
W
Marsden
Ronald G
RG
Neville
Gaylor
G
Hoskins
Frank M
FM
Sullivan
Neil
N
Drummond
D000293:Adolescent; D000328:Adult; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000523:psychology; D001294:Attitude to Health; D001507:Beclomethasone / Q000008:administration & dosage / Q000627:therapeutic use; D004334:Drug Administration Schedule; D005260:Female; D006040:Goals; D006801:Humans; D008019:Life Style; D008297:Male; D017410:Practice Guidelines as Topic; D012907:Smoking / Q000523:psychology; D006113:United Kingdom
D018927:Anti-Asthmatic Agents; D001507:Beclomethasone