Unawareness and undertreatment of asthma and allergic rhinitis in a general population

The aim of this study was to determine the extent of unawareness and undertreatment of asthma and allergic rhinitis in an adolescent and adult population in Copenhagen, Denmark.

Patients with asthma and rhinitis were recruited by a standardised asthma and rhinitis screening questionnaire. Out of a random sample of 10,877 subjects aged 14-44 years, 1149 subjects were treated or reported symptoms of asthma or rhinitis and agreed to participate. Those subjects were assessed on history, lung function tests, and skin prick tests. Disease severity and optimal treatment were decided according to the GINA and ARIA guidelines.

A total of 726 participants suffered from asthma and/or allergic rhinitis. Concomitant upper and lower airways disease was found in 47%. Seventy-five per cent were allergic and 44% with a known allergy had been tested previously. Asthma was undiagnosed and untreated in 50% of all the asthmatics. According to the guideline recommendation, 76% of asthmatics were undertreated. Rhinitis was undiagnosed in 32% of patients and 83% with moderate to severe rhinitis were undertreated. Patient knowledge about self-care and education was low.

In this population a large proportion of patients were unaware of having asthma or rhinitis. The pharmaceutical treatment and management practice were inadequate. Our study emphasises the need for additional intervention.