Methods. Based on the responses of the Delphi consensus group, an attitudinal questionnaire was developed, translated and pilot-tested in face-to-face interviews. Computer-assisted web interviews were then conducted by Kantar Health in 13 European countries. Physicians who treated fewer than 15 asthma patients a month or who had responded to previous surveys on asthma in the past 3 months were excluded.
Results. Of 1861 respondents, 1007 (54%) were eligible for inclusion; 85% of eligible respondents were respiratory specialists and 15% were primary physicians with a specialist interest in asthma, treating a mean of 59 asthma patients per month. Half (50%) of the patients with asthma were being treated with ICS/LABA fixed combinations, 15% with ICS alone, 10% with ICS/LABA free combinations, 10% with short-acting β2-agonists alone, other therapy (10%) and 5% with LABAs alone. When choosing an ICS/LABA combination, the factors considered the most important (ranked 1 or 2 out of 5) were symptom improvement (71%), ICS potency (55%), improvement in fixed expiratory volume in 1 second (FEV1; 50%), safety and tolerability (43%), speed of onset (42%), flexibility of dosing (40%) and duration of action (37%).
Conclusion: In this pan-European survey, physician attitudes to ICS/LABA therapy differed from those observed in the Delphi consensus in terms of the importance given to specific treatment attributes. However, both initiatives indicated that clinical efficacy, safety and tolerability, speed of onset of the LABA, potency of the ICS, and flexibility of dosing influence the choice of treatment in real-life practice.