Assessing asthma control: More evidence that patient perceptions fall short

Prompt recognition of poorly controlled asthma is one of the keys to avoiding asthma-related hospitalizations. Yet symptoms appear to be an unreliable indicator of the degree of airway obstruction. Even more sobering news comes from a pharmacy-based survey, which found that almost 70% of patients with poorly controlled asthma considered their asthma to be well controlled.

Laforest and associates recruited persons with asthma (aged 18 to 50 years) from 348 pharmacies in France. The participants completed a questionnaire about personal characteristics and their asthma treatment, which was linked to pharmacy records of dispensed medications. The analysis was limited to the 1048 persons who had poorly controlled asthma, according to the Asthma Control Test.

The study found that 68.5% of those with poorly controlled asthma considered their asthma to be completely controlled or well controlled. The perception of asthma control did not vary according to the frequency of symptoms, impairment in activity, or use of reliever medications or other therapies. Compared with the younger patients, those who were aged 41 to 50 years were more likely to fail to perceive inadequate asthma control. Smokers were more likely than nonsmokers to perceive inadequate control.

Although there is probably more than one explanation for the poor perception of asthma control, the authors acknowledge that improving patient education strategies is essential.