Asthma Survey Reveals Communication Gaps Between Physicians and Parents
MONTREAL – There is a disconnect in communications between physicians and parents of children with asthma, according to an analysis of data from a new global asthma survey.
Parents and physicians disagree on the amount of time dedicated to asthma education in the office; who initiates discussion about medication side effects; and the level of treatment compliance with asthma medication.
The North American pediatric findings of the Global Asthma Physician and Patient (GAPP) study also confirm what most physicians already know: Asthma medication compliance is low; patients with poor compliance experience more symptoms; and side effects lead patients to switch or drop medications.
The authors conclude that patient compliance and outcomes could be enhanced through better physician-patient communications and asthma education, and the availability of new treatment options with lower side-effect profiles, Dr. Ronald Dahl of Aarhus (Denmark) University Hospital, and his associates on the GAPP Survey Working Group reported in a poster at the Seventh International Congress on Pediatric Pulmonology.
The GAPP survey is the first-ever global quantitative survey to uncover asthma attitudes and treatment practices among patients and physicians. The survey was conducted between May and August 2005 in 16 countries and included a total of 5,482 online and telephone interviews with 1,017 parents of children diagnosed with asthma, 1,006 physicians who treat children with asthma, 1,726 adults over 18 years of age with asthma, and 1,733 physicians who treat adults.
The study, which was supported by an educational grant from Altana Pharma and conducted in cooperation with the World Allergy Organization and American College of Allergy, Asthma, and Immunology, was sufficiently powered to ensure statistical significance globally and in each country.
The pediatric analysis presented here was based on 618 interviews conducted in North America among 314 parents and 304 physicians.
Among parents interviewed, 62% reported their children's asthma as mild; 33% as moderate; and 5% as severe. In the 12 months before the interview, parents reported several events demonstrating poor asthma control such as making an unscheduled visit to their doctor (34%), going to the emergency department (11%), and admission to the hospital (5%), the authors reported.
According to parents, physicians don't discuss specific asthma management issues such as the development of an individual management plan (66%); correct inhaler technique (69%); and keeping daily symptom/medication diaries (25%). In every case, physicians' perceptions of the incidence of these discussions were higher (90%, 97%, 53%, respectively).
Consistently, parents also perceive less time is spent on asthma education than do physicians. While 18% of parents reported that during a typical office visit, no time is spent on asthma education, about 84% of physicians report spending at least half of their office time on education.
Overall, 27% of parents answered “false” or “not sure” when asked whether mild asthma attacks could be fatal, which demonstrates a general lack of understanding about the disease, the authors reported. Global findings from the survey indicate that treatment compliance increased with the level of asthma education, a trend that also was seen in local results.
Of those patients with asthma who take or had taken asthma medication, 37% of parents reported never discussing short-term side effects such as fungal infection, sore throat, or hoarseness with their physicians; and 55% reported never discussing long-term effects including weight gain, weakening of the bones or changing bone density, cataracts, or glaucoma. This compares with physician reports of 1% and 6%.
A similar disparity was seen regarding lack of parental awareness of both short- and long-term side effects of inhaled corticosteroids.
More information on the GAPP study findings is available at www.gappsurvey.org
