Patient Perceptions of Living with Severe Asthma: Challenges to Effective Management

Abstract

The funder had no role in the design of the study, data collection, analysis and interpretation or writing of the report and decision to submit for publication. Dr Rachael A Evans holds an NIHR clinical scientist 36 fellowship CS-2016-16-020. The views expressed in this article are those of the author(s) and not necessarily those of the NHS, the NIHR, or the Department of Health and Social Care. Conflicts of interest We wish to confirm that there are no known conflicts of interest associated with this publication and there has been no significant financial support for this work that could 42 have influenced its outcome.

Patients' experiences of asthma exacerbation and management: a qualitative study of severe asthma

“…However, it is also associated with systemic side effects or even with the risk of mortality, particularly when used repeatedly or for a long term [6,7,21], as some of our participants referred to its use as "biting the bullet" or "taking poison". In the literature, several qualitative studies addressed the experiences and concerns regarding the use of OCSs among severe asthmatic patients in Western countries [8,[10][11][12], and two studies [8,10] particularly focused on the experience of OCS burden, describing "oral steroid phobia", major side effects, and cost-benefit considerations when taking OCS. Our findings are generally in line with those of previous reports [8,[10][11][12], in terms of the experience of side effects and also the patients" bivalent perception of the necessity of OCSs; however, our study is a meaningful addition to the literature and also extension to Korean patients, in that it reveals several factors underlying the patient"s reliance on OCS, such as agonizing experience of exacerbations, fear of future re-worsening, and also importantly the lack of proper prior knowledge about the side effects of OCS.…”

“…Exacerbation is associated with the future risk of exacerbation, leading to progressive decline in lung function and health status of patients with severe asthma [7]. In the literature, several qualitative studies have described the experience of patients with severe asthma [8][9][10][11][12][13][14][15]. However, very few have focused on the patients" experience of asthma exacerbation and the experiences that may lead to reliance on OCSs, particularly none in Asians.…”

Balancing treatment and side-effects in severe asthma: a patient and professional perspective

“…There has been little research in this area to understand patient perspectives and the balancing act between adherence and side-effects. A recent study by A pps et al [ 1 ] highlighted the impact on an individual: “I remember talking to my GP about my concerns and he said well the answer is simply you either want to breathe or you want to be slim, which would you rather have? […] And it's like well breathe, you know, but it was really difficult to watch myself disappear with being on steroids […] I lost my cheekbones, and I remember looking in the mirror one day and the only part of me I could recognise was my hair colour and my eye colour, and everything else about me I couldn't”.…”

Non-drug treatments and rehabilitation of patients with bronchial asthma

“…Cognitive behavioral therapy significantly affects the quality of life, as measured by the appropriate questionnaire for asthmatics [114]. Psychological support should be especially in severe disease [115], and psychological training for parents whose children have asthma has been shown to be positive for both children and parents [116].…”