Asthma: individual patient perspective and current unmet needs


Ms Worstell Executive Director, Asthma and Allergy Foundation of America, 1233 20th Street, NW, Suite 402, Washington, DC 20036, USA.


Today there is an array of medication options to treat asthma and state-of-the-art guidelines to help diagnose and manage this chronic disease. Despite this, asthma morbidity and mortality rates are rising. There is an urgent need to direct educational programmes and health resources to address this disparity. A recent US survey of asthma patients and health-care providers disclosed that a large number of asthma patients do not fully understand what control of asthma really means and what treatments are available. They underestimate the severity of their condition and over-estimate how well their asthma is being controlled. More treatment choices provide the opportunity for better asthma control for more patients. However, more choices also mean an increased need for education so that the practitioners can determine the best treatment plan for each patient. Provider/patient communication must be enhanced to address patient cultural and lifestyle practices, including environmental exposures. These factors are as important as medication options for successful patient compliance in asthma control. This will require a change in clinician educator skills or more extensive use of ancillary asthma education in clinics. An interactive seminar for physicians on how to communicate better led to patient–physician encounters that were of shorter duration, had significant impact on the prescribing and communication behaviour of physicians, led to more favourable patient responses to physicians’ actions, and led to reductions in health care services use. Not all patient educational needs can be met in brief medical visits. Patient education and patient advocate organizations are essential to supplement education given by the physician. Patient organizations help develop culturally and linguistically appropriate educational materials and they organize patient assist systems that help patients exchange information, practice advice and emotional support.