Under-treatment in a nonselected population of adult patients with asthma

Background and aim: The question of undertreatment has frequently been raised concerning the management of asthma but, to date, very few studies have been carried out. In those studies that have been performed, the methodology was inadequate because they were conducted on a selected population of patients with asthma or by interviewing doctors. As part of the European Community Respiratory Health Survey, nonselected patients with asthma (22 to 44 years old) in two French cities (Paris and Montpellier), were examined to assess possible undertreatment. Methods: Patients with asthma were recruited according to a positive response to questions on asthma in a questionnaire and a positive methacholine challenge. The severity of asthma was assessed by a cumulative score, which has previously been shown to be significantly correlated with the validated clinical score of Aas. Patients were asked to attend the clinic and bring with them any medications that they regularly received. The optimal treatment of asthma was based on the International Consensus Report on the Management of Asthma. Results: According to the international guidelines, among the patients who required antiinflammatory treatment, 86.4% were undertreated in Paris and 66.7% were undertreated in Montpellier (p < 0.03, chi square test). Moreover, among the patients with severe asthma, 85% and 60%, respectively; were not receiving an antiinflammatory treatment. Conclusion: This study is the first to highlight the magnitude of undertreatment of patients with asthma in a nonselected population.