Asthma Insight & Management
Asthma Insights and Management: More Progress Needed in Asthma Care in the U.S.
Asthma is a treatable chronic illness that affects more than 22 million Americans according to the National Heart Lung and Blood Institute (NHLBI). A new survey, Asthma Insight and Management (AIM), reveals that approximately eight percent of adults in the U.S. currently have asthma. However, a much larger proportion of the general adult population surveyed (31%) report that other family members have asthma. Indeed, nearly half of the general adult population surveyed (45%) report that they or another family member have had asthma.
AIM attempts to find out how well Americans are managing the burden of asthma. Physicians today have an improved understanding of asthma as an inflammatory disease and recognize the importance of using maintenance therapy for persistent disease. But how effectively are we applying that knowledge?
The answer, according to the AIM survey, is: not very well. Results of the survey reveal that while there have been incremental declines in emergency room visits and the number of patients reporting missed work or school days due to asthma, there have been no improvements in hospitalizations or other unscheduled emergency visits for asthma over the past decade.
Adult asthma patients surveyed have a significant physical burden of disease, which produces lower self-health ratings, greater activity limitations, and more sick days and days in which patients limited their activities compared to adults without asthma. In the AIM survey, nearly twice as many adults without asthma surveyed rated their health as "excellent"
compared to those with asthma. Adults with asthma also took more than three times as many sick days
and experienced more than twice as many days in which they cut down on things they normally do for more than half of the day during the past year as adults without asthma.
Communication Between Patients and Doctors May Be a Key Consideration
One common feature of asthma is the short periods of time when asthma symptoms become more frequent or more severe. These periods of symptom worsening are generally referred to as “asthma exacerbations” by doctors. However, when doctors talk about asthma “exacerbations,” many patients don’t know what they’re talking about. While only 24 percent of asthma patients report that they have heard the term “asthma exacerbation” before, a higher percentage report that they have heard the terms "asthma flare-up" (71 percent)
and "asthma attack” (97 percent). Patients’ greater familiarity with these terms (“asthma attack” and “asthma flare-up”) as compared to the term commonly used by physicians (“asthma exacerbations”) may signal a need to rethink how we communicate about the disease.
This lack of comprehension and common vocabulary may result in many patients having very poorly or not well controlled asthma. Nearly half (47 percent) of the national sample of adults and adolescents 12 and older with asthma in the AIM survey were classified as having very poorly controlled asthma according to the survey’s classification of control, which was developed based on existing asthma management guidelines.
