Unawareness and undertreatment of asthma: follow-up in a different geographic area in Denmark.
BACKGROUND
Early detection and treatment of asthma is important to minimize morbidity and healthcare costs. The objective of this study was to investigate asthma awareness and management in a western society.


METHODS
In a random sample of 10 400 subjects aged 14-44 years, 686 (6.6%) reported symptoms of asthma in a standardized screening questionnaire. All 686 were evaluated by respiratory specialists and diagnosed by history, symptoms, lung function tests, bronchial challenges and allergy testing. Of these 686 participants, 69 (10%) had asthma alone, 205 (30%) had rhinitis alone and 217 (32%) had both asthma and rhinitis; 195 (28%) had nonasthmatic respiratory reports.


RESULTS
Awareness of asthma was found among 163 (57%) of the 286 asthmatics, and 204 (95%) had doctor-diagnosed rhinitis as well. In a multivariate regression analysis, comorbidity with rhinitis (beta = 0.489, P < 0.001), smoking (beta = -0.116, P < 0.01), doctor-diagnosed bronchitis (beta = 0.086, P < 0.05), and earlier emergency visits at hospital (beta = 0.147, P < 0.001) was significantly associated with awareness. A difference in awareness was found between those who had asthma and rhinitis (62.2%) and those who had asthma alone (40.6%) (P < 0.01). Inhaled corticosteroids (ICS) were used by 27% of those with asthma, including 12% who used both ICS and long-acting beta-agonist.


CONCLUSIONS
More than half of the persons with asthma were aware of their disorder; and the awareness was more likely in those with comorbidity of rhinitis. In general, asthma management was inadequate.
Backer
V
V
Department of Respiratory Medicine, Bispebjerg Hospital, University of Copenhagen, Bispebjerg Bakke 23, Copenhagen NV 2400, Denmark.
Nolte
H
H
Pedersen
L
L
Dam
N
N
Harving
H
H
D000280:Administration, Inhalation; D000293:Adolescent; D000318:Adrenergic beta-Agonists / Q000627:therapeutic use*; D000328:Adult; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001249:Asthma / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D016022:Case-Control Studies; D015897:Comorbidity; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006889:Hydroxycorticosteroids / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D011785:Quality Assurance, Health Care; D019984:Quality Indicators, Health Care / Q000706:statistics & numerical data*; D012220:Rhinitis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology
D000318:Adrenergic beta-Agonists; D018927:Anti-Asthmatic Agents; D006889:Hydroxycorticosteroids