Use of inhaled medications and urgent care services - Study of Canadian asthma patients

OBJECTIVE To determine asthma patients' patterns of disease and knowledge o f asthma. DESIGN Telephone survey of patients with diagnosed asthma. SETTING Residences in 10 Canadian provinces. PARTICIPANTS Patients with asthma diagnosed by a doctor: 829 men and women with a mean age of 38 +/- 7 years. MAIN OUTCOME MEASURES Classes of asthma medications, patterns of use, frequ ency and severity of asthma symptoms, use of emergency departments and urge nt medical services, participation in asthma education programs, presence o f environmental triggers, and knowledge of asthma pathophysiology and treat ment. RESULTS Four hundred fifty-six patients (55%) reported daily symptoms of as thma; 431 patients (52%) used inhaled beta(2)-agonists daily. Only 340 pati ents (41%) used inhaled corticosteroids (IC), and many used them irregularl y. A total of 579 (72%) respondents reported no unscheduled visits to a fam ily physician for worsening asthma, but one third of patients had been to a n emergency department for uncontrolled asthma in the last 5 years, and mos t of these visits had occurred during the last year. As to knowledge, 406 patients (49%) disagreed with the statement that asthm a is a lifelong condition that cannot be cured. Among IC users, only 101 (3 0%) knew that IC reduced airway inflammation; among beta(2)-agonist users, only 33% agreed that beta(2)-agonists opened the bronchial tubes. Two hundr ed forty patients (29%) reported being current cigarette smokers, and 381 ( 46%) reported having pets at home. CONCLUSIONS Daily symptoms and daily use of beta(2)-agonists are common amo ng Canadian asthma patients, and this is in excess of what is considered ac ceptable by current asthma care guidelines. Underuse of IC, inadequate know ledge of asthma symptoms and treatments, and failure to avoid asthma trigge rs were common in the population studied.