Uncontrolled asthma usually not perceived that way

NEW YORK (Reuters Health) - Two thirds of patients with uncontrolled asthma think their disease is well under control, according to a new study.

Patients with asthma can usually lead relatively normal lives with little or no restrictions, provided that they take their medications as instructed. This typically involves the use of certain medications to keep the disease at bay as well as those that are used when a flare-up occurs.

"Many asthmatic patients fail to perceive their level of disease control," Dr. Eric van Ganse, of University of Lyon, France, and colleagues write in the Annals of Allergy, Asthma, and Immunology.

In their study, the researchers examined whether personal characteristics or factors related to disease management influenced a person's ability to assess their own asthma control.

To recruit participants for the study, information on dispensed asthma medications was obtained from computerized pharmacy records at 348 participating pharmacies. The Asthma Control Test was used to measure the level of asthma control, covering frequency of episodes of breathlessness, frequency of nighttime awakenings, limitations in daily activities, and need for "rescue" medications when a flare-up occurred.

The investigators restricted the analyses to 1,048 subjects identified as having inadequate asthma control. When asked how they would rate their asthma control over the past 14 days, nearly 69 percent considered themselves to be completely or well controlled.

Failure to perceive inadequate asthma control was more likely to be found in patients between the ages of 41 and 50 years.

"The reasons for such poor perception of inadequate control by asthmatic patients deserve explanations," van Ganse and colleagues write. Low blood oxygen levels, which can occur with poorly controlled asthma, might impair a person's ability to assess their own difficulty breathing. "As well, the notion of asthma control seems poorly understood by asthmatic patients."

The team concludes the findings underscore an urgent need for better education of asthma patients about their disease, and suggest that a major part of this training should be teaching patients how to identify the first signs of a flare-up based on symptoms and limitations in daily life.

SOURCE: Annals of Allergy, Asthma, and Immunology, February 2007.