Time for a new language for asthma control: results from REALISE Asia

Abstract

Purpose

Asthma is a global health problem, and asthma prevalence in Asia is increasing. The REcognise Asthma and LInk to Symptoms and Experience Asia study assessed patients’ perception of asthma control and attitudes toward treatment in an accessible, real-life adult Asian population.

Patients and methods

An online survey of 2,467 patients with asthma from eight Asian countries/regions, aged 18–50 years, showed greater than or equal to two prescriptions in previous 2 years and access to social media. Patients were asked about their asthma symptoms, exacerbations and treatment type, views and perceptions of asthma control, attitudes toward asthma management, and sources of asthma information.

Results

Patients had a mean age of 34.2 (±7.4) years and were diagnosed with asthma for 12.5 (±9.7) years. Half had the Global Initiative for Asthma-defined uncontrolled asthma. During the previous year, 38% of patients visited the emergency department, 33% were hospitalized, and 73% had greater than or equal to one course of oral corticosteroids. About 90% of patients felt that their asthma was under control, 82% considered their condition as not serious, and 59% were concerned about their condition. In all, 66% of patients viewed asthma control as managing attacks and 24% saw it as an absence of or minimal symptoms. About 14% of patients who correctly identified their controller inhalers had controlled asthma compared to 6% who could not.

Conclusion

Patients consistently overestimated their level of asthma control contrary to what their symptoms suggest. They perceived control as management of exacerbations, reflective of a crisis-oriented mind-set. Interventions can leverage on patients’ trust in health care providers and desire for self-management via a new language to generate a paradigm shift toward symptom control and preventive care.

Video abstract

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Keywords:

• asthma control
• attitudes
• perception

Acknowledgments

This study was supported and funded by Mundipharma Pte Ltd. Online survey and statistical analysis were performed by Pei-Li Teh, Rachel Howard, Tsin-Li Chua, and Jie Sun of Research Partnership Pte Ltd. Medical writing support was provided by Sen-Kwan Tay of Research2Trials Clinical Solutions Pte Ltd.

Disclosure

The authors received honoraria from Mundipharma for their participation in the REALISE Asia Working Group meetings and discussions. Professor Price has board membership with Mundipharma and also received speaker fees, grants, and unrestricted funding support from Mundipharma. Professors Liam and Yunus and Associate Professor David-Wang and Assistant Professor Tan are members of the Asia-Pacific Advisory Board of Mundipharma. Professors Cho and Yunus and Associate Professor David-Wang and Assistant Professor Tan received speaker fees from Mundipharma in the past. Assistant Professor Tan received conference sponsorship from Mundipharma. Dr Neira is an employee of Mundipharma. The authors have no other conflicts of interest in this work.

Author contributions

All the authors were involved in conceptualizing the study design, drafting the article, or revising it critically for important intellectual content, and all the authors approved the final version to be submitted for publication. All the authors have full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.