Control of asthma under specialist care - Is it achieved?

Background: The goal of asthma treatment is control of asthma and good quality of life for asthmatic patients; however, many asthmatic patients experience symptoms and limitations. Study objectives: To examine treatment outcome in asthmatic patients under specialist care. Design: Multicenter, cross-sectional study. Setting: Four large outpatient asthma clinics in teaching hospitals in three Greek cities. Patients: Three hundred seventy-eight randomly selected patients with mild or moderate asthma (265 female patients; mean age, 42.3 years). Interventions: None. Measurements and results: Patients completed a questionnaire structured with eight domains covering patient characteristics, drug use at baseline and during exacerbations, regular follow-up, emergency visits, asthma control, symptoms, and limitations. Results show that the majority of patients have symptoms and limitations in their physical and social activities and have frequent exacerbations, while > 40% of patients think that their asthma is not well controlled. Most of our patients receive preventive medication (primarily inhaled corticosteroids, but less so long-acting beta 2-agonists [LABAs] and leukotriene antagonists), increase their use of medication in case of exacerbations and have regular follow-up. However, the report shows that 48% of patients tried to reduce their medication dose, a fact implying that compliance is not always good. Conclusions: These data indicate that the goals of asthma treatment are not achieved, even under specialist care. Perhaps more effort should be invested in patient education while an increase in the use of LABAs and leukotriene antagonists, medications that have been shown to prevent exercise-induced bronchoconstriction and improve quality of life, may help better asthma outcomes.