Presentation: Patients and Physicians Concept of Well-Controlled Asthma: Findings from Realise Asia ( World Allergy Congress)

Friday, 16 October 2015

Hall D1 Foyer (Floor 3) (Coex Convention Center)

Sang-Heon Cho, MD, PhD , Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea

David Price , Research in Real Life, Singapore, Singapore

Jaewon Jeong, MD , Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, South Korea

Diahn-Warng Perng, MD, PhD , School of Medicine, National Yang-Ming University, Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

Jiangtao Lin, MD, PhD , Department of Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China

Glenn Neira, MD , Medical Affairs Department, Mundipharma Pte Ltd, Singapore, Singapore

Background: REALISE Asia is a two-part study (Part 1 – patient survey and Part 2 – physician survey) conducted to understand patients’ and physicians’ perceptions and perspectives towards asthma and its management. We report here the extent of discrepancy in the understanding of well-controlled asthma between patients and physicians in Asia.

Methods: REALISE Asia was conducted in two parts across the following 8 countries in Asia: China, Hong Kong SAR, Indonesia, Malaysia, Philippines, Singapore, South Korea, and Taiwan. Part 1 was an online, questionnaire based survey involving 2,467 patients with asthma aged 18-50 years. Part 2 was carried out through face-to-face and online interviews amongst 375 physicians managing asthma patients, 54% of which are specialists (i.e. respiratory medicine, allergy, and clinical immunology) and the rest in primary care practice.

Results: A significantly higher proportion of specialists (95%) compared to primary care physicians or PCPs (65%) reported that they use Global Initiative for Asthma (GINA) in assessing asthma control. Only 2% of specialists stated that they do not use any guidelines compared to 22% of PCPs. While 89% of patients considered their asthma to be controlled, physicians perceived 53% of their own patients as well-controlled. Both are overestimation of the actual proportion of patients achieving control (18%) based on GINA-defined criteria. Seven out of 10 physicians mentioned that their patients’ definition of well-controlled asthma is aligned with their definition. Physicians perceived that patients relate well-controlled asthma to minimal impact on daily life (50%), absence of symptoms (48%), and no/reduced attacks (21%). This is in stark contrast with patients understanding of the concept as they related control more to having medications to cope with their symptoms (26%) or quickly control asthma attacks (15%) reflective of the crisis-oriented mind-set they have towards their disease.

Conclusions: Physicians and patients overestimate their level of asthma control. These highlight the importance of accurate assessment in clinical practice, and the role of physicians in improving the understanding of concept of well-controlled asthma amongst their patients. Standardized tools may aid in better assessment of control while using shared language in discussing treatment goals may help ensure physicians’ and patients’ concept of well-controlled asthma are more aligned.

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