Asthma in Asia: Physician perspectives on control, inhaler use and patient communications.
We examined the physician perspectives on asthma management in Asia.



An online/face-to-face, questionnaire-based survey of respiratory specialists and primary care physicians from eight Asian countries/region was carried out. The survey explored asthma control, inhaler selection, technique and use; physician-patient communications and asthma education. Inclusion criteria were >50% of practice time spent on direct patient care; and treated >30 patients with asthma per month, of which >60% were aged >12 years.



REALISE Asia (Phase 2) involved 375 physicians with average 15.9(±6.8) years of clinical experience. 89.1% of physicians reporting use of guidelines estimated that 53.2% of their patients have well-controlled (GINA-defined) asthma. Top consideration for inhaler choice was asthma severity (82.4%) and lowest, socio-economic status (32.5%). Then 54.7% of physicians checked their patients' inhaler techniques during consultations but 28.2(±19.1)% of patients were using their inhalers incorrectly; 21.1-57.9% of physicians could spot improper inhaler techniques in video demonstrations. And 79.6% of physicians believed combination inhalers could increase adherence because of convenience (53.7%), efficacy (52.7%) and usability (18.9%). Initial and follow-up consultations took 16.8(±8.4) and 9.2(±5.3) minutes, respectively. Most (85.1%) physicians used verbal conversations and least (24.5%), video demonstrations of inhaler use; 56.8% agreed that patient attitudes influenced their treatment approach.



Physicians and patients have different views of 'well-controlled' asthma. Although physicians informed patients about asthma and inhaler usage, they overestimated actual usage and patients' knowledge was sub-optimal. Physician-patient interactions can be augmented with understanding of patient attitudes, visual aids and ancillary support to perform physical demonstrations to improve treatment outcomes.
a Centre of Academic Primary Care, University of Aberdeen , Aberdeen , United Kingdom.|b Research in Real Life , Singapore.
David
D
Price
c Section of Pulmonary Medicine, University of the Philippines-Philippine General Hospital , Manila , Philippines.
Aileen
A
David-Wang
d College of Medicine, Seoul National University , Seoul , Republic of Korea.
Sang-Heon
SH
Cho
e Department of Medicine , University of Hong Kong, Hong Kong Special Administrative Region of the People's Republic of China.
James Chung-Man
JC
Ho
f College of Medicine, Inje University , Goyang , Republic of Korea.
Jae-Won
JW
Jeong
g Faculty of Medicine, University of Malaya , Kuala Lumpur , Malaysia.
Chong-Kin
CK
Liam
h Respiratory Medicine Department , China-Japan Friendship Hospital , Beijing , People's Republic of China.
Jiangtao
J
Lin
i Institute of Respiratory Medicine , Kuala Lumpur , Malaysia.
Abdul Razak
AR
Muttalif
j School of Medicine, National Yang-Ming University , Taipei , Taiwan.|k Department of Chest Medicine , Taipei Veterans General Hospital , Taipei , Taiwan.
Diahn-Warng
DW
Perng
l National University Hospital , Singapore.
Tze-Lee
TL
Tan
m Persahabatan Hospital, University of Indonesia , Jakarta , Indonesia.
Faisal
F
Yunus
n Medical Affairs Department , Mundipharma Pte Ltd , Singapore.
Glenn
G
Neira
D000280:Administration, Inhalation; D000293:Adolescent; D000328:Adult; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D001208:Asia; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D001296:Audiovisual Aids; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009330:Nebulizers and Vaporizers; D010353:Patient Education as Topic / Q000458:organization & administration*; D010817:Physician-Patient Relations; D011320:Primary Health Care; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D013038:Specialization; D055815:Young Adult
D018927:Anti-Asthmatic Agents
Physician-patient communications; attitudes; education; inhaler techniques