Asthma in Asia: Physician perspectives on control, inhaler use and patient communications

Price D 1 , David-Wang A 2 , Cho SH 3 , Ho JC 4 , Jeong JW 5 , Liam CK 6 Show all authors , Lin J 7 , Muttalif AR 8 , Perng DW 9 , Tan TL 10 , Yunus F 11 , Neira G 12

Affiliations 

  • 1 a Centre of Academic Primary Care, University of Aberdeen , Aberdeen , United Kingdom
  • 2 c Section of Pulmonary Medicine, University of the Philippines-Philippine General Hospital , Manila , Philippines
  • 3 d College of Medicine, Seoul National University , Seoul , Republic of Korea
  • 4 e Department of Medicine , University of Hong Kong, Hong Kong Special Administrative Region of the People's Republic of China
  • 5 f College of Medicine, Inje University , Goyang , Republic of Korea
  • 6 g Faculty of Medicine, University of Malaya , Kuala Lumpur , Malaysia
  • 7 h Respiratory Medicine Department , China-Japan Friendship Hospital , Beijing , People's Republic of China
  • 8 i Institute of Respiratory Medicine , Kuala Lumpur , Malaysia
  • 9 j School of Medicine, National Yang-Ming University , Taipei , Taiwan
  • 10 l National University Hospital , Singapore
  • 11 m Persahabatan Hospital, University of Indonesia , Jakarta , Indonesia
  • 12 n Medical Affairs Department , Mundipharma Pte Ltd , Singapore
J Asthma, 2016 09;53(7):761-9.
PMID: 27096388 DOI: 10.3109/02770903.2016.1141951

Abstract

OBJECTIVE: We examined the physician perspectives on asthma management in Asia.

METHODS: An online/face-to-face, questionnaire-based survey of respiratory specialists and primary care physicians from eight Asian countries/region was carried out. The survey explored asthma control, inhaler selection, technique and use; physician-patient communications and asthma education. Inclusion criteria were >50% of practice time spent on direct patient care; and treated >30 patients with asthma per month, of which >60% were aged >12 years.

RESULTS: REALISE Asia (Phase 2) involved 375 physicians with average 15.9(±6.8) years of clinical experience. 89.1% of physicians reporting use of guidelines estimated that 53.2% of their patients have well-controlled (GINA-defined) asthma. Top consideration for inhaler choice was asthma severity (82.4%) and lowest, socio-economic status (32.5%). Then 54.7% of physicians checked their patients' inhaler techniques during consultations but 28.2(±19.1)% of patients were using their inhalers incorrectly; 21.1-57.9% of physicians could spot improper inhaler techniques in video demonstrations. And 79.6% of physicians believed combination inhalers could increase adherence because of convenience (53.7%), efficacy (52.7%) and usability (18.9%). Initial and follow-up consultations took 16.8(±8.4) and 9.2(±5.3) minutes, respectively. Most (85.1%) physicians used verbal conversations and least (24.5%), video demonstrations of inhaler use; 56.8% agreed that patient attitudes influenced their treatment approach.

CONCLUSION: Physicians and patients have different views of 'well-controlled' asthma. Although physicians informed patients about asthma and inhaler usage, they overestimated actual usage and patients' knowledge was sub-optimal. Physician-patient interactions can be augmented with understanding of patient attitudes, visual aids and ancillary support to perform physical demonstrations to improve treatment outcomes.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

MeSH terms
Similar publications