title: Asthma control: do patients' and physicians' opinions fit in with patients' asthma control status?
abstract: The aim of this study was to determine the level of asthma control and the concordance between physicians' and patients' opinions and the real patients' situation. A total of 777 subjects (55% female) with asthma were recruited. The study comprised a 4-week follow-up period, during which subjects completed a diary recording peak expiratory flow (PEF), symptoms, and use of rescue medication. At the end, both physicians and patients rated asthma control status. The level of control was evaluated using a composite measure. Agreement among subjective assessments of asthma control by patients and physicians and objective evaluation with the composite measure was assessed through kappa scores. A total of 518 (67%) patients had "not well-controlled asthma," being the remaining "totally controlled" (8%) or "well-controlled" (25%). "Not well-controlled asthma" was more frequent in smokers (82%) than in ex-smokers (70%) or in non-smokers (62%; p=0.0002). Kappa scores between patients' and physicians' opinions and the real patients' status were 0.02 (95% CI, 0.01-0.05) and 0.07 (95% CI, 0.03-0.09), respectively. In conclusion, current level of asthma control is suboptimal for a majority (67%) of patients in Spain. Besides, asthma control is worse in smokers. Neither patients' nor physicians' opinions agree with patients' real situation. Both patients and physicians accept as normal a suboptimal status of their disease.
authors.affiliation: Allergology, Hospital Dr. Peset, Valencia, Spain.
authors.forename: L
authors.initials: L
authors.lastname: Prieto
authors.forename: C
authors.initials: C
authors.lastname: Badiola
authors.forename: J R
authors.initials: JR
authors.lastname: Villa
authors.forename: V
authors.initials: V
authors.lastname: Plaza
authors.forename: J
authors.initials: J
authors.lastname: Molina
authors.forename: E
authors.initials: E
authors.lastname: Cimas
mesh_terms: D000318:Adrenergic beta-Agonists / Q000627:therapeutic use*; D000328:Adult; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D001291:Attitude of Health Personnel; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D010366:Peak Expiratory Flow Rate / Q000187:drug effects; D010820:Physicians / Q000523:psychology / Q000706:statistics & numerical data; D013030:Spain; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000318:Adrenergic beta-Agonists