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. 2025 Dec;42(12):6045-6058.
doi: 10.1007/s12325-025-03346-w. Epub 2025 Oct 6.

The Global Patient Perspective on Uncontrolled Moderate-to-Severe Asthma: Reducing Delays in Diagnosis and Treatment

Karen Rance  1 , Brenda Young  2 , Gretchen McCreary  2 , Stephanie Williams  2 , Marilyn Urrutia-Pereira  3 , Kristen Willard  2 , Ghulam Mustafa  4 , Purvi Parikh  5 , Tonya Winders  2 , Ruth Tal-Singer  2
Affiliations

The Global Patient Perspective on Uncontrolled Moderate-to-Severe Asthma: Reducing Delays in Diagnosis and Treatment

Karen Rance et al. Adv Ther. 2025 Dec.

Abstract

Introduction: Uncontrolled asthma greatly affects quality of life globally and highlights unmet medical needs. Despite advances in treatment and care, many patients still experience delayed diagnoses, poor symptom control, and a reliance on emergency care. The Global Allergy and Airways Patient Platform (GAAPP) surveyed patients with moderate-to-severe uncontrolled asthma to assess their care experiences.

Methods: The GAAPP Time Clock Survey is a cross-sectional, online, multilingual survey of adults living in Brazil, Germany, Italy, Japan, Saudi Arabia, the United Arab Emirates, and the US. The survey examined diagnosis, symptoms, treatment outcomes, challenges in self-management, and timelines for care coordination.

Results: A total of 1401 individuals with self-reported asthma using combination inhaler therapy and experiencing symptoms were enrolled in this study. Among these participants, 56% reported waiting more than 1 month to undergo pulmonary function testing for diagnosis. Additionally, 51% indicated minimal to no improvement in quality of life despite treatment interventions. Difficulties in asthma management were reported by 42% of participants, with some describing the process as difficult or very difficult. Approximately 32% of individuals used daily corticosteroids. Nearly half of the cohort consulted three or more healthcare providers in their pursuit of effective asthma management. Emergency department visits were common, with 50% seeking urgent care for uncontrolled symptoms and 35% requiring hospitalization.

Conclusion: This study underscores the importance of policy reforms that prioritize timely diagnosis, shared decision-making, and long-term disease control. Improving outcomes for patients with uncontrolled asthma will require both clinical innovation and structural transformation.

Keywords: Asthma diagnosis delays; Asthma management barriers; Biologic therapies; GINA step 3; Global patient survey; Moderate-to-severe asthma; Multidisciplinary asthma care; Uncontrolled asthma.

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Conflict of interest statement

Declarations. Conflict of Interest: Karen Rance, Brenda Young, Gretchen McCreary, Stephanie Williams, Kristen Willard, and Ghulam Mustafa, as well as Marilyn Urrutia Pereira, have no disclosures to report. Purvi Parikh is a speaker for Genentech. Tonya Winders is a paid advisor and speaker for AstraZeneca, Chiesi, GSK, Novartis, Roche, and Sanofi Regeneron. Ruth Tal-Singer is a shareholder of GSK and holds share options in ENA Respiratory and reports personal fees from AstraZeneca, Boehringer Ingelheim, ENA Respiratory, Janssen, Roche, Vocalis Health, Teva, ImmunoMet, Renovion, Samay Health, GSK, ItayAndBeyond, COPD Foundation, and GlobalSkin. Ethical Approval: The United States-based research team received an exemption for the English version of the survey, recruitment text, images, and consent form from a central institutional review board (BRANY, Lake Success, NY), granted an exempt determination for the English version of the survey, recruitment text, images. No incentives were provided for survey participation. The study adhered to the ethical principles outlined in the Declaration of Helsinki and followed the Consensus-Based Checklist for Reporting of Survey Studies (CROSS) [5]. The survey was administered electronically and included a mix of multiple-choice, Likert scale, and open-ended questions to gather both quantitative and qualitative data. All participants provided electronic consent prior to beginning the survey, during which the study’s purpose, procedures, and other relevant details were clearly explained. Participation was voluntary, with the option to withdraw any time.

Figures

Fig. 1
Fig. 1
Participant Distribution by Country Geographic distribution of the survey population (N = 1401) across seven participating countries
Fig. 2
Fig. 2
Respondents’ Symptom Report Self-reported frequency of common asthma symptoms, including cough, shortness of breath, mucus production, wheezing, chest tightness, and rescue inhaler use
Fig. 3
Fig. 3
Impact of Asthma on Quality of Life Reported effects of uncontrolled asthma on leisure activities, sleep, healthcare use, mental health, and daily responsibilities
See this image and copyright information in PMC

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