Asthmatic patients' poor awareness of inadequate disease control: a pharmacy-based survey.
BACKGROUND
Many asthmatic patients fail to perceive their level of disease control.


OBJECTIVE
To investigate whether patients' ability to identify asthma control varied with personal characteristics or factors related to disease management.


METHODS
Asthmatic patients were consecutively recruited at 348 pharmacies. They completed a questionnaire (regarding personal characteristics and asthma management) linked to pharmacies records of dispensed medications. The Asthma Control Test questionnaire includes 4 dimensions of asthma control (activity limitations, dyspnea, nocturnal awakenings, and rescue medication use) and assesses patients' perception of control ("How would you rate your asthma control during the past 14 days?"). Analyses were restricted to patients with inadequate control. Patients' perception of control was compared across the other dimensions of the questionnaire. The correlates of patients' failure to perceive inadequate asthma control were investigated.


RESULTS
Seven hundred eighteen (68.5%) of the 1,048 patients with inadequate asthma control and documented perception of control considered themselves to be "completely" or "well" controlled. Patients' perception of control did not vary with each dimension of inadequate control. High rates of failure to perceive poor control were observed in patients with at least weekly dyspneas (60%) or nocturnal symptoms (60%). Failure to perceive inadequate control was more likely in patients aged 41 to 50 years (odds ratio, 1.51; 95% confidence interval, 1.05-2.15). No significant effect of factors related to asthma management was observed.


CONCLUSIONS
Patients with most uncontrolled asthma have difficulty in properly perceiving their level of disease control regardless of their personal characteristics or disease management. The reasons for this poor perception should be investigated. Education programs should be created that focus on knowledge of asthma miscontrol criteria.
Laforest
Laurent
L
Université de Lyon, France.
Van Ganse
Eric
E
Devouassoux
Gilles
G
Osman
Liesl M
LM
Brice
Kitio
K
Massol
Jacques
J
Bauguil
Gisele
G
Chamba
Genevieve
G
D000293:Adolescent; D000328:Adult; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy / Q000523:psychology*; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D010465:Perception; D010594:Pharmacies; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
D018927:Anti-Asthmatic Agents