Asthma: the poor control of the disease is too often

Asthma remains poorly controlled in the majority of patients, even among those receiving treatment background, especially because they do not properly adjust their treatment during exacerbations of their disease, lamented a French specialist , Professor Alain Didier, head of the pulmonology department of the CHU of Toulouse.

Insufficient control

This was during a press conference in Paris that he is back on the results of the Inspire (International asthma patient insight research) study, presented at the congress of the European Respiratory Society (ERS).

This survey included 2,046 adult asthmatics with moderate to severe forms of the disease, recruited in eight European countries (Germany, Belgium, Spain, France, Italy, Netherlands, United Kingdom and Sweden), followed by a general practitioner or a pulmonologist and taking background therapy (inhaled corticosteroids and / or beta-2 agonists long-acting).

Main lesson of this survey: the control of asthma remains insufficient Even among patients on background therapy, with 68% of participants poorly controlled during the seven days preceding the survey.

As a corollary to this finding, the authors of this study observed an excessive consumption of drugs to treat seizures (beta-2-agonists short duration of action). Thus, 71% of respondents reported using these drugs daily (while more than four weeks taken characterize poor control).

Moreover, the number of exacerbations occurring each year is still very high: fourteen average for uncontrolled asthma and seven patients yet considered well controlled. In total, 47% of patients surveyed experienced a worsening requiring hospitalization, emergency room visits or emergency consultation during the twelve months preceding the survey.

Improper adjustment of treatment

If 61% of respondents said they easily recognize the signs of a worsening of their disease (shortness of breath, cold, infection, chest tightness, coughing and wheezing onset), when they occur, patients do not necessarily adopt good behavior, noted the authors of this study.

Indeed, when patients have certainly tend to change their treatment themselves, but they usually hold an increase in their consumption crisis treatment (bronchodilators short-acting, beta-2-agonists, which n ' no effect on inflammation). They proceed to an adjustment of the dose of their background therapy only in a second time, at the peak of symptoms. Insofar as the basic treatment is the inflammation and reduces aggravation, asthmatics should instead adjust their treatment melts earlier, as soon as signs of a worsening occur, to prevent this kind of episode.

"The period of accentuation of symptoms, interval of six days between the start and the peak of the worsening offers them a deadline for early intervention, as recommended by their physician, including increasing doses of inhaled corticosteroids to reduce symptoms or prevent further ", reads the press release issued on the occasion of this conference.

Develop therapeutic education

Thus, says Dr. Alain Didier even though "it is important that patients instinctively adapt their treatment to the circumstances, it is still necessary that they do so with accuracy, which is not necessarily the case."

According to him, "the analysis of the results of the INSPIRE study shows that even when the patient knows that he can change the doses of background therapy, there is too little action, arguing that bronchodilators short duration action will be more effective through a difficult period. "

For French specialist, the development of therapeutic education is the way to change the situation. Therapeutic education detailing the different possibilities to fight against the phenomena of worsening asthma may help patients who, according to the results of the study Inspire already know how to recognize the signs of deterioration, be able to show change themselves and feel their treatment, 90% of them, confident in their ability to support personal asthma.

"What they lack is an adequate information, as well as support that could be offered by the physician during follow-up visits for asthma or part of a structure'' school breath ", he considers.