Understanding patients' perceptions of asthma control: a qualitative study

Abstract

Asthma control is suboptimal for many sufferers despite the existence of effective treatments. Patients' self-management is influenced by their perceptions of asthma and its treatment. This study explored sufferers' perceptions of asthma control and their influence on self-management behaviours.Participants (n=42) recruited from primary and secondary care asthma clinics in London in the UK each underwent a qualitative interview exploring perceptions and experiences of asthma control. Purposive sampling ensured variation in disease severity, degree of asthma control, age and socioeconomic status. Grounded theory was employed in thematic analysis of transcribed interviews.Five themes relating to perceptions of asthma control and self-management were identified: personal meaning of control, intermittent prevention, compromising control to avoid medication, pharmacological agents overemphasised in control and the role of asthma review in control. Within the first theme, some participants had an internal barometer of the level of symptoms that indicated their asthma was getting "out of control" that was set much higher than Asthma Control Test criteria.The findings provide new insights into patients' perceptions of asthma control. Symptoms indicative of poor control were often tolerated as part of living with asthma. Identification of barriers and drivers to self-management highlight potential targets for strategies aimed at optimising asthma management.

The first impression counts for lung function: One year to make a difference in asthma prognosis

“…This study clearly shows that physicians need to address not only asthma symptoms and medication use but also lung function parameters and QoL regularly, as these reflect different dimensions of the disease that do not always correlate. 6,7 These differences may indeed reflect the discrepancy between physician and patient-reported outcomes. Patients reporting asthma control frequently have uncontrolled disease (according to the Global Initiative for Asthma (GINA) guidelines) or even low FEV 1 % values.…”

Perceptions of childhood asthma and its control among Malays in Malaysia: a qualitative study

“…Some perceive asthma as hereditary and others perceive it as contagious 9,10 . Mild asthma is often perceived as normal, despite symptoms indicating poor control 11 . Some parents and physicians tend to underestimate the severity of children's asthma and overestimate their asthma control 12 .…”

“…Some parents and physicians tend to underestimate the severity of children's asthma and overestimate their asthma control 12 . Asthma self-management is influenced by one's perception of asthma 11 which may vary between ethnic groups due to diverse culture 13,14 . For instance, during the fasting period, Muslims would adjust their medication to enable them to fast as some Muslims are taught the use of an inhaler invalidates the fast 15 .…”

The first year of treatment predicts the prognosis of asthma over 25 y—A prospective study

“…Asthma is a chronic disease that requires long-term treatment as well as guided self-management to control and modify the treatment; this means that the patients expect asthma management to be useful, including the subjective perception of their asthma control, although these do not always correspond with the level of lung function. 12,13 The aim of this investigator-driven, real-life 25-year follow-up study of adult-onset asthma was both to ascertain the long-term treatment results and to investigate whether the forced expiratory volume in one-second percentage of the predicted value (FEV 1 %) at the end of the first treatment year predicts the long-term prognosis. Furthermore, the correlation between the patients' assessment of their asthma control and the measured FEV 1 % was examined.…”