Asthma control and management in 8,000 European patients: the REcognise Asthma and LInk to Symptoms and Experience (REALISE) survey

Abstract

Background: Asthma is one of the most common chronic diseases in the world, and previous studies have reported low levels of control. Recent developments in the availability and use of online sources of information about asthma might add to patients' knowledge and help improve control.

Aims: To investigate whether asthma control has improved by assessing levels of symptoms, exacerbations and Global Initiative for Asthma-defined control in a real-life population of patients who use the Internet and social media, as well as evaluate patient perception of control and attitudes to asthma.

Methods: Online surveys were conducted among 8,000 patients with asthma (aged 18-50 years, ≥2 prescriptions in the previous 2 years, use of social media) from 11 European countries.

Results: Levels of asthma control were low: 45% of respondents had uncontrolled asthma. Acute exacerbations were common: 44% of respondents reported having used oral steroids for asthma in the previous 12 months, 24% had visited an emergency department and 12% had been hospitalised. More than 80% of respondents (overall, and among those with a history of exacerbations) considered their asthma to be controlled. Of those who had an exacerbation requiring oral steroids, 75% regarded their asthma as not serious.

Conclusions: Asthma control in Europe remains poor; symptoms and exacerbations are common. Many patients regard their asthma as controlled and not serious despite experiencing symptoms and exacerbations. There is a need to assess patients' control, risk and inhaler technique, and to ensure that patients are prescribed, and take, appropriate treatments.

Figure 1

Survey design. ^aParticipants were excluded if they failed one or more screening questions (see Methods). ^bData shown for individual answers to screening questions; 49,717 respondents answered all screening questions before being screened and hence the total number of reasons for exclusion exceeds 69,646.

Figure 2

Asthma symptoms with the greatest impact on respondents’ lives for the overall population. Q. Which asthma symptoms do you find affect you most? Place in order, with 1 having the most impact on your life and 5 the least. Base: N=8,000. Numbers shown are percentages.

Figure 3

Daily use of preventer medication. Q: Which statement best describes how you take your regular asthma treatment? This is your preventer inhaler, which is usually brown, orange or red. Base: respondents taking a preventer inhaler (overall: n=3,481; Global Initiative for Asthma-defined controlled: n=620; partially controlled: n=1,171; uncontrolled: n=1,690).

Figure 4

Respondents’ attitudes towards their inhaler. Q: To what extent do you agree with the following statements? Data shown for strongly agree plus tend to agree. Base overall: n=8,000; Global Initiative for Asthma-defined controlled: n=1,604; partially controlled: n=2,785; uncontrolled: n=3,611.

Figure 5

Sources of information about asthma. Q: If you were to look for information about asthma, which of the following would you use? Combined=all respondents who selected at least one answer from the list of possible options. Base: N=8,000.