Adherence to treatment guidelines and good asthma control in Finland

ABSTRACT

Background

Asthma program in Finland decreased asthma-related mortality and expenses of care on national level, but there is lack of data on adherence to treatment guidelines and disease control on individual level. We aimed to assess adherence to guidelines and disease control among Finnish adult asthmatics.

Methods

Questionnaires were sent in Finland to 2000 randomly selected recipients aged 18–80 years, who had bought medication for obstructive airways disease during the previous 12 months. The questionnaire included questions on asthma medication, exacerbations, self-management and follow-up. Asthma symptom control was assessed by the Asthma Control Test (ACT).

Results

A high proportion (82.4%) of the 541 responders with physician-diagnosed asthma reported regular use of asthma medication and 97.1% of them used inhaled corticosteroids. Almost all (97.0%) of the asthmatics were taught how to use their inhaler and 78.4% had an asthma self-management plan, but only 35.7% reported regular annual follow-up visits. According to symptoms, 60.0% had their asthma well-controlled (ACT score ≥20). On the other hand, 29.2% had a course of oral corticosteroid and 21.8% had an asthma-related unscheduled health care visit during the previous year, but only 2.6% reported a hospitalization. Asthma control was better in those not using regular asthma medication.

Conclusions

The guidelines are well adopted in Finnish adult asthma care except for regular follow-up visits. Majority of patients had good symptom control and hospitalizations were rare. Better asthma control among those not using regular asthma medication implies they are not undertreated but have a mild disease.

KEYWORDS:

• Asthma
• adult
• control
• symptom
• management
• guideline
• medication
• follow-up
• exacerbation

Supplemental data

Supplemental data for this article can be accessed online at https://doi.org/10.1080/20018525.2022.2149918.

Contribution

JP, JK and LL designed the study, created the questionnaire and collected the data. JP, PS and PJ conducted the statistical analyses with help from LL and JK. JP, PS, PJ, JK and LL interpreted the data, critically reviewed the manuscript, read and approved the manuscript before submission.

Data availability statement

Data available on request from the authors.

Disclosure statement

The authors report no conflicts of interest related to this study.

Disclaimer

None of the funders were involved in the planning, execution, drafting or write-up of this study.

Additional information

Funding

This study was supported by grants from Tampere Tuberculosis Foundation, Competitive State Research Financing of the Expert Responsibility area of Tampere University Hospital, the Research Foundation of the Pulmonary Diseases, Allergy Research Foundation, and the Foundation of the Finnish Anti-Tuberculosis Association.

Notes on contributors

Johanna Pakkasela

Johanna Pakkasela is a specialist in Respiratory Medicine at Tampere University Hospital, Finland. Her research focuses on asthma, allergy and outcomes of patients with asthma.

Petri Salmela

Petri Salmela is a specialist in Respiratory Medicine at Tampere University Hospital, Finland. His research focuses on outcomes and management of patients with chronic obstructive respiratory diseases.

Pekka Juntunen

Pekka Juntunen is specialising in Respiratory Medicine at Tampere University, Finland. His research focuses on outcomes and management of patients with chronic obstructive respiratory diseases.

Jussi Karjalainen

Jussi Karjalainen is Head of the Allergy Centre at Tampere University, Finland. His research focuses on phenotypes and clinical and occupational outcomes among patients with asthma.

Lauri Lehtimäki

Lauri Lehtimäki is a Professor of Respiratory Medicine at Tampere University, Finland. His recent research focuses on airway inflammation in asthma, COPD and occupational lung diseases.