Nearly half of adult Americans with asthma and more than a quarter of children with asthma who responded to a nationally representative survey do not have their disease well controlled, according to the Asthma USA survey, which was presented today at the International Conference of the American Thoracic Society meeting in Toronto.
The survey found that not well controlled asthma had significant medical consequences. Adults with uncontrolled asthma were more likely to require treatment with oral corticosteroids, visit the emergency department or be admitted to the hospital than those whose asthma was well controlled. Children with uncontrolled asthma were also more likely to require urgent medical care. Past research has shown that uncontrolled asthma can put patients at risk for increased asthma symptoms, sudden asthma attacks, hospitalizations and even death.
Asthma Treatment and Symptoms
"We have made quantum leaps in asthma treatment in the last decade, but the Asthma USA results demonstrate that enormous numbers of patients are living with asthma that is still not well controlled, putting them at significant health risk," said David Stempel, MD, director of clinical medicine for GlaxoSmithKline. "These findings remind us that improvements in care have not been uniform and underscore the critical need to improve education for both patients and healthcare providers in the management of asthma."
According to the National Institutes of Health Guidelines for the Diagnosis and Management of Asthma, signs of poor asthma control include waking at night with asthma symptoms, trips to the hospital and the need for quick-relief medication such as albuterol more than twice a week for asthma symptoms.
The survey examined responses from more than 81,500 households, with asthma control assessed with the Asthma Control Test (ACT), a validated assessment questionnaire recommended by national treatment guidelines for determining a patient's level of asthma control. Of the more than 10,000 adults with self-reported asthma taking the ACT, 41 percent had a score of 19 or less, which indicates not well controlled asthma.
The survey also examined scores from the Childhood Asthma Control Test and ACT to determine the level of asthma control in more than 3,000 children respondents* between the ages of 4 and 17 and found that asthma control in children is also deficient. According to the findings, 31 percent of children with asthma between the ages of 4 and 11 and 25 percent of those between 12 and 17 did not have well-controlled asthma.
About the Asthma USA Survey
The Asthma USA study was conducted by GlaxoSmithKline in cooperation with National Family Opinion Survey Group and designed to evaluate uncontrolled asthma and assess demographic variables associated with asthma risk in the general population of the United States.
This was a cross sectional mailed survey administered to a representative national sample of 134,401 households recruited from a consumer panel of households managed by NFO/TNS in May, June and July 2007, a time when asthma-related medical complications traditionally see a seasonal decline. Surveys were returned for 60.6 percent of households, including information on 10,139 adults with a self-reported physician diagnosis of asthma completing the Asthma Control Test. Data for 38,323 children aged 4 to 17 was returned with a total of 1,991 children 4 to 11 years with asthma and 1,265 adolescents 12-17 years with asthma included in the survey.
The data presented at the ATS meeting represents the first phase of the study which is the baseline data. A subset of the initial population will be followed on a quarterly basis to generate longitudinal data on asthma control, missed work and school, medication use and seasonal variation in asthma control.