Survey cites gaps in knowledge about disease and potential drug side effects
By Anne Scheck
HealthDay Reporter
MONDAY, May 22 (HealthDay News) -- Most people with asthma who take medication rarely discuss side effects with a doctor and many of them stop taking their medicine or skip doses during treatment, a large international survey finds.
The culprit appears to be poor doctor-patient communication.
"The data in the United States show that doctors don't seem to be spending as much time as they should with asthma patients," said survey team member Dr. Michael A. Kaliner, of the Institute for Asthma & Allergy.
Because asthma is a chronic disease, good control of it takes commitment on the part of both patients and their health-care providers, he said. However, when physicians are under pressure to see many patients in a relatively short time period, which is the case in some health maintenance organizations, conversations about asthma care may be rushed or incomplete, he suggested.
The findings, from the Global Asthma Physician and Patient (GAPP) survey, involved nearly 3,500 adults and 16 countries. The results show just how serious the communication gaps in asthma treatment can be: An overwhelming majority of asthma patients -- 73 percent -- say they never or rarely discuss side effects with their physician; and nearly one in five people with the condition say they are unaware of short-term side effects of medication, such as dryness in the throat, coughing or hoarseness. However, only 5 percent of physicians who prescribe treatments associated with these possible side effects say they think patients don't know about them.
National guidelines for asthma management call for treatment plans that are written, discussed and provided by the doctor in partnership with the patient. Such action plans are important to patients with moderate-to-severe asthma, according to the guidelines, because they encourage open communication.
However, some studies have shown that these written plans are often absent. In one study of emergency-room visits involving more than 500 patients, less than 10 percent of the asthma sufferers who came in need of care had action plans for dealing with their asthma. "We gave them the plans, once they came to the emergency department," noted one of the lead investigators, Dr. Loren Yamamoto, professor of pediatrics at the University of Hawaii.
However, doing so took so much time that an extra staff person was needed to carry out the duty, Yamamoto said. After the study was completed, that staff member could no longer be funded. "So, our issuing action plans during that period was an artifact of the study," he said.
The results of the survey were expected to be presented Monday at the International Conference of the American Thoracic Society in San Diego.
SOURCES: Michael A. Kaliner, M.D., Institute for Asthma & Allergy, Chevy Chase, Md.; Loren Yamamoto, M.D., professor, pediatrics, University of Hawaii, Honolulu; May 22, 2006, presentation, International Conference of the American Thoracic Society, San Diego
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