Managing Asthma Well and Sustainably - Patient Perspectives Explored

Area of Science:

• Respiratory Medicine
• Environmental Health
• Patient-Centered Care

Background:

• Asthma affects 300 million globally, with widespread use of short-acting beta2-agonist (SABA) inhalers contradicting guidelines.
• SABA overuse correlates with poor asthma control and significant carbon emissions, presenting a need to reduce reliance.
• Patient perspectives on inhaler use, self-management, and environmental impact are not well understood.

Purpose of the Study:

• To explore Australian asthma patients' understanding, preferences, and perspectives on inhaler types and environmental impact.
• To investigate factors influencing inhaler choice and self-management strategies in individuals with asthma.
• To identify barriers and facilitators to adopting more sustainable asthma management practices.

Main Methods:

• Conducted in-depth, semi-structured interviews with 23 adults using regular asthma inhalers.
• Utilized a pre-interview online survey for demographic and asthma history data.
• Employed thematic analysis with an inductive framework for qualitative interview data.

Main Results:

• Most participants lacked awareness of inhaler device types and their environmental impact, expressing surprise at pMDI emissions.
• Despite valuing sustainability, patients prioritized fast-acting SABA pMDIs for perceived emergency effectiveness, influenced by familiarity and fear of exacerbations.
• Clinician recommendations heavily influenced inhaler choice, with limited patient involvement in decision-making; cost and access barriers contributed to knowledge gaps.

Conclusions:

• Environmental concerns alone are insufficient to change asthma management practices.
• Familiarity, habit, and fear of asthma exacerbations are significant drivers of treatment choices.
• Strengthening clinician expertise and multi-disciplinary care, including nurses and pharmacists, can improve patient support and shared decision-making.