Royal Brompton Hospital, London, SW3 6NP, UK.
Boehringer Ingelheim UK, Bracknell, RG12 8YS, UK.
NPJ Prim Care Respir Med. 2017 Aug 11;27(1):48. doi: 10.1038/s41533-017-0050-x.
Perceptions of asthma control often vary between patients and physicians. This cross-sectional survey provided UK-specific data on actual and perceived asthma control in patients (18-75 years) attending routine asthma reviews in primary, secondary and tertiary settings. Differences between healthcare professionals' (HCP) and patients' perceptions of asthma control were evaluated via an online questionnaire and compared to a control-the validated asthma control test (ACT)-which patients completed. Treated patients (at least a short acting ß-agonist) with a documented diagnosis of asthma were enroled and consented within a month of their last appointment. Patients were grouped according to the British Thoracic Society (BTS)/Scottish Intercollegiate Guidelines Network (SIGN) 2014 treatment guidelines (BTS/SIGN steps 1-5). A total of 260 patients were screened: 234 were eligible for enrolment: 33, 52, 50, 49 and 50 patients in steps 1-5, respectively. Seventy per cent (164) were women. The percentage of patients aged 45-64 years was 47.4%. HCPs classed 70% (164) as non-smokers. 84.2% of patients and 73.9% of HCPs perceived that asthma was controlled but ACT results suggest that asthma was only controlled in 54.7% of patients (ACT score ≥20). Patients in steps 4 and 5 had the highest levels of uncontrolled asthma. Correct agreement between ACT score with perceptions of controlled or uncontrolled asthma occurred in 67.9% of patients and 68.8% of HCPs; the poorest levels of agreement occurred in patients in steps 4 and 5. Uncontrolled asthma is common in UK patients. High proportions of patients and HCPs have incorrect perceptions of asthma control, especially in relation to patients with asthma in steps 4 and 5.
MISPERCEPTIONS OF CONTROL ABOUND AMONG UK PATIENTS AND DOCTORS: Asthma patients and their doctors often misperceive whether the disease is under control, according to a British study. Andrew Menzies-Gow from Royal Brompton Hospital in London and Gavin Chiu from Boehringer Ingelheim UK in Bracknell used an online questionnaire to assess perceptions of asthma control among 234 patients and their healthcare providers. All participants had at least intermittent asthma that required occasional treatment; many had more severe disease. The researchers found that 84% of patients and 74% of doctors thought the asthma was well controlled, but results of the Asthma Control Test indicated only 55% of patients objectively achieved disease control. Correct agreement between the validated test and more subjective perceptions occurred in only 68 % of patients and 69% of doctors. Addressing this mismatch could go a long way to improving asthma control among British patients.
本横断面研究提供了英国在初级、二级和三级医疗机构常规接受哮喘评估的患者（18-75 岁）中实际和感知的哮喘控制的具体数据。通过在线问卷评估了医疗保健专业人员（HCP）和患者对哮喘控制的感知差异，并与患者完成的经验证的哮喘控制测试（ACT）进行了比较。在过去预约后一个月内，记录了诊断为哮喘的接受治疗的患者（至少使用短效β-激动剂）并征得其同意。根据英国胸科协会（BTS）/苏格兰校际指南网络（SIGN）2014 年治疗指南（BTS/SIGN 第 1-5 步），将患者分组。共筛选了 260 名患者：234 名符合入组条件：分别为第 1-5 步的 33、52、50、49 和 50 名患者。70%（164 名）为女性。45-64 岁患者的比例为 47.4%。HCP 将 70%（164 名）归类为不吸烟者。84.2%的患者和 73.9%的 HCP 认为哮喘得到控制，但 ACT 结果表明只有 54.7%的患者（ACT 评分≥20）的哮喘得到控制。第 4 步和第 5 步的患者有最高水平的未控制哮喘。ACT 评分与控制或未控制哮喘的感知之间的正确一致性在 67.9%的患者和 68.8%的 HCP 中发生；在第 4 步和第 5 步的患者中，一致性水平最差。在英国患者中，未控制的哮喘很常见。高比例的患者和 HCP 对哮喘控制存在错误的认识，尤其是在与处于第 4 步和第 5 步的哮喘患者有关时。
