Asthma in Asia: Physician perspectives on control, inhaler use and patient communications

David Price, Aileen David-Wang, Sang Heon Cho, James Chung Man Ho, Jae Won Jeong, Chong Kin Liam, Jiangtao Lin, Abdul Razak Muttalif, Diahn Warng Perng, Tze Lee Tan, Faisal Yunus, Glenn Neira

Research output: Contribution to journalArticlepeer-review

13 Citations (Scopus)

Abstract

Abstract: Objective: We examined the physician perspectives on asthma management in Asia. Methods: An online/face-to-face, questionnaire-based survey of respiratory specialists and primary care physicians from eight Asian countries/region was carried out. The survey explored asthma control, inhaler selection, technique and use; physician-patient communications and asthma education. Inclusion criteria were >50% of practice time spent on direct patient care; and treated >30 patients with asthma per month, of which >60% were aged >12 years. Results: REALISE Asia (Phase 2) involved 375 physicians with average 15.9(±6.8) years of clinical experience. 89.1% of physicians reporting use of guidelines estimated that 53.2% of their patients have well-controlled (GINA-defined) asthma. Top consideration for inhaler choice was asthma severity (82.4%) and lowest, socio-economic status (32.5%). Then 54.7% of physicians checked their patients’ inhaler techniques during consultations but 28.2(±19.1)% of patients were using their inhalers incorrectly; 21.1–57.9% of physicians could spot improper inhaler techniques in video demonstrations. And 79.6% of physicians believed combination inhalers could increase adherence because of convenience (53.7%), efficacy (52.7%) and usability (18.9%). Initial and follow-up consultations took 16.8(±8.4) and 9.2(±5.3) minutes, respectively. Most (85.1%) physicians used verbal conversations and least (24.5%), video demonstrations of inhaler use; 56.8% agreed that patient attitudes influenced their treatment approach. Conclusion: Physicians and patients have different views of ‘well-controlled’ asthma. Although physicians informed patients about asthma and inhaler usage, they overestimated actual usage and patients’ knowledge was sub-optimal. Physician-patient interactions can be augmented with understanding of patient attitudes, visual aids and ancillary support to perform physical demonstrations to improve treatment outcomes.

Original languageEnglish
Pages (from-to)761-769
Number of pages9
JournalJournal of Asthma
Volume53
Issue number7
DOIs
Publication statusPublished - 8 Aug 2016

Keywords

  • attitudes
  • education
  • inhaler techniques
  • Physician-patient communications

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