http://orcid.org/0000-0001-5865-489X
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Abstract
Background: People with severe asthma experience frequent life-threatening acute asthma events. A Lancet commission recently highlighted that terms “exacerbations” and “flare-ups” are seen to trivialize these episodes and recommended use of the term “attacks.” Clinicians however, preferentially use the term “exacerbation” and some guidelines recommend the use of “exacerbation” with patients.
Objective: This descriptive qualitative study aimed to understand the patient’s experience and perspectives of these events and language used to describe them.
Methods: Semi-structured one-on-one interviews were conducted in Australia and the UK in 18 people with severe asthma and 10 with mild-moderate asthma regarding their usage and preferences for such terminologies. Additionally, nine people with severe asthma participated in two focus groups in which use of preferred terminology was explored.
Results: Mean age of participants was 57 ± 14.03 yr and 65% were female. A total 67 quotes were recorded in which 16 participants with severe asthma spontaneously used either the term “attack,” “flare-up” and/or “exacerbation.” Of these quotes, all 16 participants used “attack,” one used all three terms and two used both “exacerbation” and “attack.” The term “attack” was used to describe frightening events having major impacts on participant’s lives, whereas “exacerbation” and “flare-up” were used to refer to both severe and mild, transient asthma-related events.
Conclusion: Usage of the term “attack” was preferred by patients with severe asthma. Adoption of this language may assist in patient-clinician communication and disease management and outcomes. Wider stakeholder engagement is needed to confirm this suggestion.
| Abbreviations | ||
| FEV1 | = | forced expiratory volume in 1 second |
| ATS | = | American Thoracic Society |
| ERS | = | European Respiratory Society |
| ACQ | = | Asthma Control Questionnaire |
| ICS | = | inhaled corticosteroids |
| OCS | = | oral corticosteroids |
| BTS | = | British Thoracic Society |
| SIGN | = | Scottish Intercollegiate Guidelines Network |
| WAP | = | written action plan. |
Declaration of interest
The study was supported by the Center of Excellence in Severe Asthma, The Hunter Medical Research Institute and the John Hunter Charitable Trust. All authors have no conflicts of interest to declare.