Only 5 per cent of asthma patients are receiving treatment that meets all the criteria for control recommended by guidelines, according to European researchers.
Dr K. Rabe (department of pulmonology, Leiden university medical centre, the Netherlands) and colleagues undertook the Asthma Insights and Reality in Europe (AIRE) study, in which 2,803 patients (including 753 children) with asthma were surveyed about symptoms, treatment and perceived control of the disease.
The answers to the survey were compared with recommendations made by the Global Initiative for Asthma, a strategy for asthma management set up by a working group of the World Health Organisation and the National Heart, Lung and Blood Institute. The researchers found that only 5.3 per cent of patients met all the criteria for asthma symptom control set out in the strategy.
Over one-third of children and half of adults reported daytime symptoms at least once a week, with asthma-related sleep disturbances in 28.0 and 30.5 per cent, respectively. Episodes of cough, wheezing, chest tightness and shortness of breath occurred in 51.5 per cent of children and 57.2 per cent of adults at least once a month. In addition, 60.5 per cent of children and 45.0 per cent of adults reported that their general practitioner had never performed a lung function test on them.
Patient perception of their asthma control differed markedly from more objective assessments of disease severity, they say. Despite the high frequency of asthma symptoms and acute health care visits reported in the survey, 76.5 per cent of children and 65.9 per cent of adults commented that they had had no asthma symptoms or only mild asthma during the previous four weeks.
Dr Rabe and colleagues say that the findings of the AIRE study suggest that some patients may be "dangerously under treated". The AIRE study took place in seven European countries (the UK, France, Germany, Italy, the Netherlands, Spain and Sweden) and was funded by Glaxo Wellcome (European Respiratory Journal
2000;16:802).