Overestimation of asthma control and misperception of the place of short-acting β2-agonists in asthma management: a prospective, real-world study among physicians in Poland.

Abstract

Objective: Overestimation of asthma control remains a substantial healthcare issue. Overuse of short-acting β2-agonists (SABA), one of the aspects of poor asthma control, was highlighted by the SABINA project as a worldwide problem. The objective of this study was to investigate the asthma control assessment and the perception of the SABA role in asthma therapy among Polish allergists, pulmonologists, and general practitioners.

Methods: The study included 253 Polish allergists, pulmonologists, and general practitioners.Data were gathered using a qualitative questionnaire regarding physicians' practices and opinions and a quantitative one - an extended Patient Diary Study with information about asthma control of 2482 patients. The answers were compared with Global Initiative for Asthma (GINA) criteria.

Results: Physicians assessed asthma control at 69.1-89.8% of visits, based mainly on symptoms (96% of physicians), followed by drug consumption (65-80%) and diagnostic tests (40-79%). According to GINA standards, 32.4-43.3% of patients had controlled and 27.3-33.9% uncontrolled asthma. Physicians in all specialties overestimated the percentage of patients with controlled asthma and the level of control was overestimated for 68-84% of uncontrolled patients. Over 90% of physicians agreed or strongly agreed that SABA consumption is an important indicator of asthma control; 58-81% agreed that SABA consumption should be monitored as an indicator of asthma control; 74-90% stated that SABA were rescue medications that patients must have; 59-68% agreed that SABA consumption should be reduced.

Conclusions: The results of this study show a strong need for physicians' education regarding objective asthma control assessment and the role of SABA in asthma therapy.