Features of asthma management: quantifying the patient perspective
1 University of Aberdeen, Department of General Practice and Primary Care Aberdeen, AB25 2AY, UK
2 Education For Health, Chief Executive, Warwick, CV34 4AB, UK
3 Thorpewood Medical Group, Respiratory Nurse, Norwich, NR7 9QL, UK
4 University of Sheffield, Health Economics and Decision Science, Sheffield, S10 2TN, UK
5 Adelphi Group LTD, Research Director, Macclesfield, SK10 5JB, UK
6 Imperial College, Chair in Respiratory Medicine, London, W6 8RP, UK
BMC Pulmonary Medicine 2007, 7:16 doi:10.1186/1471-2466-7-16Published: 6 December 2007
In the management of asthma, features of care important to patients may not be fully appreciated. This study quantifies the importance of different features of asthma management from the patient perspective. This may assist in the development of personalised management strategies.
We used the technique of discrete choice experiment (DCE). Patients over 18 years of age with asthma, prescribed and taking medicine at step 3 of the UK guidelines were recruited from 15 general (family) practices in three areas of the UK. 147 evaluable questionnaires were returned from a total of 348 sent out. The outcome measures were the relative importance to patients of features of asthma management and the impact of changes in asthma management, as measured by utility shift between the features tested.
The largest shift in mean utility values was recorded in "number of inhalers" and "use of inhaled steroid". Use of a personal asthma action plan was ranked next highest.
This study suggests that adults with moderate or severe asthma would trade some improvements in symptom relief in favour of, for example, simpler treatment regimens that use as few inhalers as possible and a lower dose of inhaled steroid.