Unmet Needs of Older People with Asthma: Cross-Sectional Survey

Abstract

Introduction. Asthma in older people is a major cause of disease burden in Australia and is projected to increase over the next two decades. Current guidelines for asthma care rely predominantly on studies from younger populations. Methods. We undertook a cross-sectional survey of older people with asthma to identify their concerns and their perceived asthma symptom burden. One hundred and ninety-nine people over 55 years of age with asthma were recruited from community pharmacies, in the states of Victoria and NSW, Australia. Results. One-hundred and twenty (62%) participants reported “perfectly” or “very well controlled” asthma over the past month, and 78% claimed adherence to asthma treatment. Despite this, 105 (55%) reported experiencing moderate to severe symptoms and 58 (30%) moderate to extreme restrictions on their lifestyle in the past month. Exacerbations were also common with over one-third of participants seeking emergency asthma care or requiring oral corticosteroids in the past 12 months. In spite of 80% of participants reporting confidence of how to manage their asthma properly, only 10% said they would call an ambulance or visit an Emergency Department if their asthma was “out of control.” Further asthma self-management education was considered desirable by two-thirds. However, those over 65 years preferred less autonomy in decision-making compared to those under 65 years. Conclusion. Older people with asthma experience a high symptom burden. A simplified version of our questionnaire could assist GPs, specialists, and asthma educators to identify the individual needs of older patients and to tailor their delivery of asthma care accordingly.

• Asthma Needs Questionnaire
• asthma self-management
• patient autonomy
• tailoring care

Acknowledgements

This study was funded by the Co-operative Research Centre for Asthma and Airways.

CJ oversees an institutional education program that has received funding from AstraZeneca to help undertake educational activities and assist in employing a staff member implementing this. CJ has received fees from GlaxoSmithKline, AstraZeneca, Bayer, and Novartis PL for speaking at meetings, providing consultative advice, and attending or chairing advisory boards. JD has received fees for speaking/being on advisory boards and/or support for travel to scientific meetings from AstraZeneca, GSK, Merck, and Novartis.

Declaration of Interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.