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Patients' perception of asthma severity
Alain Lurie1, Christophe Marsala, Sarah Hartley
1Service de Pneumologie, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, 27 rue du Faubourg Saint-Jacques, F-75679 Paris Cedex 14, France. alain.lurie@laposte.net
Respiratory Medicine
|July 25, 2007
Summary
Patients often underestimate asthma severity compared to doctors. Asthma severity assessment should include patient-reported outcomes like the Asthma-Related Quality of Life Questionnaire (AQLQ) and symptom perception.
Area of Science:
- Pulmonary Medicine
- Health Psychology
- Decision Science
Background:
- Asthma severity assessment typically relies on objective measures (OS) evaluated by healthcare professionals.
- Patient perception of asthma severity (PS) may differ significantly from OS, impacting self-management and treatment adherence.
Purpose of the Study:
- To identify patient-specific variables influencing perceived asthma severity (PS) using fuzzy decision-making analysis (FDMA).
- To compare patient-derived PS variables with objective severity (OS) criteria from the Global Initiative for Asthma (GINA) guidelines.
Main Methods:
- A cross-sectional observational study involving 113 outpatients with varying asthma severity.
- Patients rated their asthma severity (PS), while physicians assessed objective severity (OS). Questionnaires evaluated dyspnea, treatment efficacy, AQLQ, sociodemographics, and asthma characteristics.
Main Results:
- A significant discrepancy (p<0.01) was observed between PS and OS, with patients tending to underestimate their asthma severity.
- Patients' PS was primarily influenced by subjective factors such as AQLQ scores and dyspnea, not objective clinical indicators like symptom frequency or peak flow rates.
- Asthma duration and treatment characteristics also played a role in patients' PS determination.
Conclusions:
- FDMA successfully identified key variables patients utilize for assessing their asthma severity.
- The study highlights a notable divergence between patient and physician perceptions of asthma severity.
- Integrating patient-reported outcomes, specifically AQLQ measures, alongside physician assessments is recommended for a comprehensive evaluation of asthma severity.
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