"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
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
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.