REASONS FOR DELAY IN SEEKING TREATMENT FOR ACUTE ASTHMA - THE PATIENTS PERSPECTIVE

Increased morbidity and mortality due to asthma suggested the need to investigate whether persons with asthma report delay in seeking medica l care during acute asthma exacerbations and the reasons they gave for delay. We interviewed 95 asthmatic adults, 36 men and 59 women, using a critical incident technique to discover how patients responded to a cute asthma symptom episodes. Subjects were interviewed once per month for a total of three interviews. All subjects had physician-diagnosed asthma for a mean of 16.8 +/- 14.5 years. Eighty-six percent of the s ample (n = 82) reported delay in seeking medical care for severe asthm a symptoms. Seven reasons for delay were identified: uncertainty, disr uption, minimization, fear of systemic corticosteroid, previous bad ex periences in emergency departments, the need to ''tough it out'' alone , and economic reasons. Seventy-one subjects (86.5%) reported three or more reasons for delay. Thirteen subjects (16%) identified pivotal ep isodes in which they realized they could die from asthma and as a resu lt, no longer delayed. People with asthma often delay seeking urgent c are for acute episodes for a variety of reasons. Some of these reasons are modifiable. Clear directions from health professionals to guide p atients in responding to acute asthma episodes are needed. Asthma acti on plans written by the primary physician may be a positive agent of c hange for those who delay.