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J Asthma. 2018 Jun;55(6):684-694. doi: 10.1080/02770903.2017.1353611. Epub 2017 Sep 8.

Lack of asthma and rhinitis control in general practitioner-managed patients prescribed fixed-dose combination therapy in Australia.

Author information

1
a Woolcock Institute of Medical Research , Quality Use of Respiratory Medicines , Glebe , Australia.
2
b Optimum Patient Care , Research Support , Westwick, Cambridge , United Kingdom of Great Britain and Northern Ireland.
3
c Department Respiratory Medicine , Royal Prince Alfred Hospital , Missenden Road, Camperdown , Australia.
4
d Faculty of Medicine , The University of Sydney, The Woolcock Institute of Medical Research , Sydney , Australia.
5
e Primary Care Interest Group at European Academy of Allergy and Clinical Immunology , University of Edinburgh , Edinburgh , UK.
6
f Centre for Academic Primary Care, The Institute of Applied Health Sciences , University of Aberdeen , Aberdeen , UK.

Abstract

OBJECTIVES:

The first aim of the study (i) assess the current asthma status of general-practitioner-managed patients receiving regular fixed-dose combination inhaled corticosteroid and long-acting beta2 agonist (FDC ICS/LABA) therapy and (ii) explore patients' perceptions of asthma control and attitudes/behaviors regarding preventer inhaler use.

METHODS:

A cross-sectional observational study of Australian adults with a current physician diagnosis of asthma receiving ≥2 prescriptions of FDC ICS/LABA therapy in the previous year, who were recruited through general practice to receive a structured in-depth asthma review between May 2012 and January 2014. Descriptive statistics and Chi-Square tests for independence were used for associations across asthma control levels.

RESULTS:

Only 11.5% of the patients had controlled asthma based on guideline-defined criteria. Contrarily, 66.5% of the patients considered their asthma to be well controlled. Incidence of acute asthma exacerbations in the previous year was 26.5% and 45.6% of the patients were without a diagnosis of rhinitis. Asthma medication use and inhaler technique were sub-optimal; only 41.0% of the preventer users reported everyday use. The side effects of medication were common and more frequently reported among uncontrolled and partially controlled patients.

CONCLUSIONS:

The study revealed the extent to which asthma management needs to be improved in this patient cohort and the numerous unmet needs regarding the current state of asthma care. Not only there is a need for continuous education of patients, but also education of health care practitioners to better understand the way in which patient's perceptions impact on asthma management practices, incorporating these findings into clinical decision making.

KEYWORDS:

Adherence; inhaler; management; medication:preventer; primary care; side effects

PMID:
28886264
DOI:
10.1080/02770903.2017.1353611
[Indexed for MEDLINE]

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