Hidden burden: discrepancies between patient-reported and clinically documented severe asthma exacerbations

Area of Science:

• Pulmonology
• Clinical Medicine
• Patient Reported Outcomes

Background:

• Accurate asthma exacerbation frequency is vital for effective disease management.
• Discrepancies often exist between patient recall and clinical documentation of exacerbations.

Purpose of the Study:

• To investigate the characteristics of discrepancies between patient-reported and clinically documented asthma exacerbations.
• To identify factors associated with under-reporting and over-reporting of exacerbations.

Main Methods:

• Retrospective review of 289 asthma patients over a one-year period.
• Severe exacerbations defined by systemic corticosteroid use (≥3 days).
• Patients categorized into concordant, under-reporting, or over-reporting groups based on event counts.

Main Results:

• Weak concordance (κ = 0.26) between patient reports and medical records.
• 11.4% under-reported, 4.1% over-reported severe exacerbations.
• Under-reporting linked to younger age, GINA step 5, and lower Asthma Control Test (ACT) scores.

Conclusions:

• A significant portion of asthma patients misperceive their annual exacerbation frequency.
• Patients with severe or poorly controlled asthma require focused attention due to higher reporting inaccuracies.