Unsatisfactory asthma control: astonishing evidence from general practitioners and respiratory medicine specialists

The aim of asthma therapy is to achieve and maintain disease control. Clinicians' behavior is crucial in terms of prescribing the best possible treatment, carrying out appropriate follow-up, and ensuring adherence to treatment. Although clinical trials have demonstrated that asthma control is an achievable goal, real-life data show that this objective is still far from being reached.

To investigate physician-related factors that can influence successful asthma management.

In 2008, 811 general practitioners (GPs) and 230 respiratory medicine specialists attending a continuous medical education program completed a questionnaire prior to beginning the course on aspects related to asthma pathogenesis and control, applicability of research and guidelines in daily practice, and doctor-patient relations.

The level of knowledge among GPs and specialists regarding the use of control tools was not optimal, with the Asthma Control Test used by 20.15% of GPs and 42.92% of specialists. The respondents were also largely unable to correctly identify level of asthma control, with approximately just 20% providing correct answers. Although chronic inflammation was considered the main feature of asthma by more than 90% of the 2 groups, they inexplicably believed that up to 40% of patients might not require long-term treatment. Both GPs and specialists preferred a continuous fixed-dose regimen (57.69% and 54.21%, respectively) and did not tend to favor self-management plans, believing that these were only feasible in a very small percentage of patients.

Our findings provide one possible explanation of why asthma control levels are currently unsatisfactory in real life.