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Open Access Highly Accessed Research article

Attitudes and actions of asthma patients on regular maintenance therapy: the INSPIRE study

Martyn R Partridge1*, Thys van der Molen2, Sven-Erik Myrseth3 and William W Busse4

Author Affiliations

1 Department of Respiratory Medicine, Faculty of Medicine, Imperial College London, London, UK

2 Department of General Practice, University Medical Centre Groningen (UMCG), University of Groningen, Groningen, The Netherlands

3 European Federation of Allergy and Airways Diseases Patients' Association (EFA), Brussels, Belgium

4 Department of Medicine, University of Wisconsin, Madison, USA

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BMC Pulmonary Medicine 2006, 6:13  doi:10.1186/1471-2466-6-13

Published: 13 June 2006

Abstract

Background

This study examined the attitudes and actions of 3415 physician-recruited adults aged ≥ 16 years with asthma in eleven countries who were prescribed regular maintenance therapy with inhaled corticosteroids or inhaled corticosteroids plus long-acting β2-agonists.

Methods

Structured interviews were conducted to assess medication use, asthma control, and patients' ability to recognise and self-manage worsening asthma.

Results

Despite being prescribed regular maintenance therapy, 74% of patients used short-acting β2-agonists daily and 51% were classified by the Asthma Control Questionnaire as having uncontrolled asthma. Even patients with well-controlled asthma reported an average of 6 worsenings/year. The mean period from the onset to the peak symptoms of a worsening was 5.1 days. Although most patients recognised the early signs of worsenings, the most common response was to increase short-acting β2-agonist use; inhaled corticosteroids were increased to a lesser extent at the peak of a worsening.

Conclusion

Previous studies of this nature have also reported considerable patient morbidity, but in those studies approximately three-quarters of patients were not receiving regular maintenance therapy and not all had a physician-confirmed diagnosis of asthma. This study shows that patients with asthma receiving regular maintenance therapy still have high levels of inadequately controlled asthma. The study also shows that patients recognise deteriorating asthma control and adjust their medication during episodes of worsening. However, they often adjust treatment in an inappropriate manner, which represents a window of missed opportunity.