Patients' perceptions of asthma control and impact on attitudes and self-management

The objective of this work was to describe the incidence of chronic breathi ng problems, particularly asthma-related breathing problems, in a cross-sec tion of the United States population and to assess the perceived impact of these problems on daily living. An initial screening survey was used in a n ationwide panel of 30,000 households; an in-depth follow-up questionnaire w as sent to a random sample of respondents who reported a breathing problem. A sample (n = 2685) of respondents who reported persistent cough, shortnes s of breath, or wheezing within the previous 2 years were sent a newly deve loped questionnaire. A subsample (n = 723) of respondents reported a primar y diagnosis of asthma and of these, 59.4% were female and 90.2% were white. Their mean age was 37.4 years. Respondents (n 723) characterized their lev el of perceived asthma control as completely controlled, well controlled, s omewhat controlled, or poorly/not controlled. At least 31% of those with a perception of some control and 59% of those with a perception of poor/no co ntrol reported their breathing problems had increased in the last year. Tho se who perceived their asthma-related breathing problems as poorly controll ed reported significantly greater symptom frequency, activity restriction, fears and concerns about their breathing difficulties, less helpful coping strategies, and less confidence in their doctor's ability to care for them. Responses to many of the questions indicated that the worst levels of dise ase control were associated with poorer quality of life and a more negative perception of the disease and its effects on daily living. A significant p ortion of the U.S. population appears to suffer from chronic breathing prob lems; this requires confirmation and further exploration to reduce the pote ntial mortality and morbidity due to asthma in the United States.