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. 2024 Nov 24:17:1207-1226.
doi: 10.2147/JAA.S483020. eCollection 2024.

Delving into Uncontrolled or Severe Asthma: Perspectives from Patients and Healthcare Professionals in a Cross-Sectional Study

Eleonora Volpato #  1   2 , Vincenzo Pennisi #  3 , Alfio Pennisi  3 , Alessio Piraino  4 , Paolo I Banfi  2 , Salvatore D'Antonio  5 , Stefano Centanni  6 , Luca Cavalieri  7 , Mattia Ramaccia  7 , Filomena Bugliaro  8 , Simona Barbaglia  9 , Antonietta Cappuccio  10 , Roberta Termini  10 , Maria Giulia Marini  10
Affiliations

Delving into Uncontrolled or Severe Asthma: Perspectives from Patients and Healthcare Professionals in a Cross-Sectional Study

Eleonora Volpato et al. J Asthma Allergy. .

Abstract

Background: Despite the effectiveness of inhalation therapy, uncontrolled or severe asthma remains prevalent challenges in respiratory care Narrative Medicine (NM) offers a linguistic approach to comprehending illness experiences, thereby providing a framework for advancing healthcare.

Aim: The primary aim of this study was to gather narratives from individuals grappling with severe or uncontrolled asthma and their Healthcare Professionals (HCPs), in order to explore the intricate interplay among quality of care, quality of life, psychological and social determinants, and adherence patterns.

Methods: A cross-sectional NM study was conducted in Italy from February to December 2023, encompassing 135 patients with uncontrolled or severe asthma (54.7% male; mean age: 56.7 years) and 47 HCPs (64.9% male; mean age: 54.3 years). A mixed-method approach was adopted to scrutinize themes, language nuances, emotional expressions, and narrative classifications.

Results: Patients with uncontrolled or severe asthma reported an average illness duration of 4.46 years, with exacerbations occurring over the past 20.9 months. Pulmonologists (83% of HCPs) played a predominant role in diagnosing and treating the disease in 96.1% of patients. Additionally, participants with severe asthma reported higher healthcare needs. The most reported emotions were fatigue (25.96%) and a sense of suffocation (11.53%). Upon commencing treatment, while experiencing physical improvement, patients predominantly expressed feelings of "submission/dependence" on medication (28%), followed by "fear" (21%) and "serenity/joy" (21%). HCPs, primarily pulmonologists (83%), emphasized the importance of raising awareness among specialists and General Practitioners (GPs), disseminating information, optimizing prescriptions, implementing phenotyping, tailoring therapy, and considering paediatric needs.

Conclusion: These findings contribute to a deeper understanding of patient perspectives, facilitate personalized interventions, and underscore the factors influencing therapeutic adherence in uncontrolled or severe asthma.

Keywords: adherence; narrative medicine; quality of life; severe asthma; uncontrolled asthma.

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Conflict of interest statement

Dr Eleonora Volpato reports support for this study from ISTUD. Dr Luca Cavalieri and Dr Mattia Ramaccia are employees of Chiesi Italia S.p.A. and Dr Alessio Piraino is an employee of Chiesi Farmaceutici S.p.A. The other authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Flow chart of participant selection.
Figure 2
Figure 2
Main information about severe or uncontrolled asthma, reported as Mean, distinguished between female and male respondents.
Figure 3
Figure 3
Therapy that participants report has been prescribed.
Figure 4
Figure 4
Additional costs reported by participants, incurred annually.
Figure 5
Figure 5
Lost workdays, distinguished by gender.
Figure 6
Figure 6
The impact on work and reasons given by participants with severe or uncontrolled asthma, distinguished between the total sample and by gender.
Figure 7
Figure 7
Frequency of symptoms as reported by participants.
Figure 8
Figure 8
Metaphors used by HealthCare Professionals (HCPs) and patients to describe severe or uncontrolled asthma.
See this image and copyright information in PMC

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