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Asthma Survey Reveals Unmet Needs for Asthmatics

Results from the first-ever global quantitative survey on unmet needs in asthma treatment, unveiled this week in London, demonstrate significant inconsistencies between how physicians’ and patients’ assess current asthma treatment on issues that may affect health outcomes. Some of these treatment issues include medication side effects, patient education and physician-patient communication. The Global Asthma Physician and Patient (GAPP) Survey, a 16-country worldwide research study, was conducted to highlight the impact of asthma, a disease that is growing in prevalence by approximately 50 percent every decade, on a global scale.

"Ongoing physician-patient communication is essential in treating chronic conditions such as asthma, and the GAPP Survey reveals there is much room to improve this dialogue in every country we studied," stated G. Walter Canonica, MD, University of Genova, Genova, Italy, for the World Allergy Organization. "One place to start is in the area of side effects, where results demonstrate significant disconnects between physicians and patients."

The research shows that a patients actual awareness of side effects of asthma medications is often different that the perceived patient awareness of side effects among physicians. Findings suggest that almost one-third (31%) of patients say they are "unaware" of the potential for long-term side effects associated with inhaled corticosteroid steroid (ICS) asthma treatments, while physicians believe patient awareness of side effects is much higher. Only three percent of physicians believe patients are "unaware" of the potential for short-term side effects, and seven percent for long-term side effects.

Patients Who Experience Side Effects May Not Take Medication
Thirty-four percent of patients who have taken medication believe to have experienced short-term side effects, including oral thrush, pharyngitis or hoarseness from their asthma medications, and 19% believe to have experienced long-term side effects.

Patients who have experienced side effects frequently cite them as a reason for non-compliance with treatment; only 26% of patients report that they are compliant at least half the time. Patients who did not comply with their treatment regimens report a greater impact on their health and quality of life, including increased symptoms (69%) and more frequent asthma attacks or exacerbations (41%). Physicians significantly over-estimated how often their patients comply with treatment regimens.

"These findings reveal clearly defined unmet needs in the asthma treatment category," said Dr. Carlos E. Baena-Cagnani, Catholic University of Cordoba, Cordoba, Argentina, for the World Allergy Organization. "Patients who did not take their asthma medication as instructed report that their asthma has a greater impact on their health and quality of life. Better patient education and new treatments may address some of the issues raised in this survey and, potentially improve patient outcomes."

Inconsistent Reports on Amount of Time Spent Educating Patients
In each country surveyed, patients and physicians report dramatically different assessments of how much time is spent on education during office visits: 23% of patients worldwide estimated that no time during their office visits is spent discussing techniques for successful asthma management; yet, 87% of physicians estimated that up to one-half of their office visits with asthma patients is spent on the topic of asthma management.

Another noteworthy finding is that a large number of physicians state that they discuss side effects with their patients, yet, up to one-half of patients report never discussing short- or long-term side effects with their physicians.

The GAPP Survey not only defines a clear unmet need in asthma treatment, but also reveals that there is direct relationship between physician-patient communication and treatment compliance. Patients who report having more discussions with their physicians about techniques for successful asthma management report greater compliance with treatment regimens.

Physicians and Patients Both Agree There is a Need for Better Asthma Medication
Although patient and physician assessments of asthma management differ, they do agree that currently available asthma treatments have lots of room for improvement. While 95% of physicians believe ICS are the "gold standard" for asthma treatment, they report being least satisfied with "side effects" of currently available ICS.

85% of physicians would likely prescribe a new ICS if it included an improved safety and tolerability profile. In particular, a new ICS with comparable efficacy and an improved tolerability profile is widely supported by a variety of patient subgroups, for whom asthma has had a particularly acute effect on their lives.

Asthma Survey Methodology
Harris Interactive(R) conducted the survey on behalf of the GAPP Survey Advisory Board via online, telephone and face-to-face interviews between May 18 and August 24, 2005. A total of 3,459 interviews were conducted (1,726 adults age 18+ who have been diagnosed with asthma and 1,733 generalist or specialist physicians who treat adults) in 16 countries: Australia, Belgium, Brazil, Canada, France, Germany, Ireland, Italy, Japan, The Netherlands, Poland, South Africa, Spain, Switzerland, the UK and the U.S. Sample sizes for each country were about 100 each for patients and physicians, except in the U.S., where the sample sizes were about 200 for each group. Physicians had to meet the following criteria: currently practicing medicine for 3-30 years, sees at least three adult asthma patients per week, writes at least one prescription for asthma medications per week. Generalists include family practitioners, general practitioners, internal medicine practitioners, and specialists include allergists, pulmonologists and respirologists.

The U.S. data were the only data weighted. Physician data were weighted by physician specialty, gender and years in practice to reflect the characteristics of physicians in the master file of physicians in the American Medical Association. Patient data were weighted by gender, education, age, household, income and region to reflect the characteristics of adult asthma patients from the National Health Interview. Data from the other countries surveyed were not weighted.

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