title: Asthma out of control? A structured review of recent patient surveys.
abstract: BACKGROUND
  An understanding of the needs and behaviors of asthma patients is important in developing an asthma-related healthcare policy. The primary goal of the present review was to assess patient perspectives on key issues in asthma and its management, as captured in patient surveys.
  
  
  METHODS
  Local, national, and multinational asthma surveys were reviewed to assess patient perspectives, and where possible healthcare provider (HCP) perspectives, on key issues, including diagnosis, treatment, control, quality of life, and other patient-centered outcomes. Twenty-four surveys, conducted or published between 1997 and 2003 in Europe and North America, were included in this review. Substantial differences among studies prevented a formal meta-analysis; instead, data were pooled to allow for general comparisons and qualitative analysis.
  
  
  RESULTS
  The results indicate that patients' knowledge of the underlying causes of asthma and treatment options remains inadequate. Moreover, patients often tolerate poor symptom control, possess meager knowledge of correct drug usage, and display insufficient adherence to therapy. Many patients have a low expectation of receiving an appropriate therapy or of having a positive encounter with the HCP. Among HCPs, there is evidence of inadequate understanding of disease etiology and poor or unstructured communication with patients, resulting often in inaccurate assessment of disease severity. Moreover, patients often underreport their symptoms and severity, which in turn could lead to misclassification and undertreatment.
  
  
  CONCLUSIONS
  Improving patient education about the importance of achieving optimal asthma control, along with improved communication between patients and HCPs, emphasizing treatment options and optimal treatment of inflammation, may lead to better outcomes and improved asthma management in daily practice.
authors.affiliation: Infection, Inflammation and Repair AIR Division, Level F, South Block, MP810, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK. sth@soton.ac.uk
authors.forename: Stephen T
authors.initials: ST
authors.lastname: Holgate
authors.forename: David
authors.initials: D
authors.lastname: Price
authors.forename: Erkka
authors.initials: E
authors.lastname: Valovirta
mesh_terms: D000328:Adult; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001249:Asthma / Q000175:diagnosis / Q000628:therapy*; D001291:Attitude of Health Personnel; D002648:Child; D017281:Cost of Illness; D005060:Europe; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D009656:North America; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011788:Quality of Life
chemical_list: D018927:Anti-Asthmatic Agents