Asthma G.A.P.

Full Survey Findings (PDF)

Survey Findings

Key results from the survey include information about patient perceptions of asthma and associated risks, patient perceptions and usage of asthma medication, and physicians’ attitudes about asthma.

Patient Perceptions of Asthma and Its Risks

Asthma patients (n=1001) acknowledge asthma is a serious health concern but there’s little consensus about what constitutes “well-controlled” asthma.

• Two thirds of all asthma patients (66%) believe that asthma is a very or extremely serious condition.
• Virtually all patients (97%) agree there are serious risks associated with uncontrolled asthma.
• Nine in ten patients (88%) believe asthma is caused by airway inflammation, three in four believe it’s caused by airway obstruction (76%) or genetics (73%), and six in ten (59%) by mucus production.
• Over half of all patients agree that their asthma is well controlled if they only have two urgent doctor visits in a year (56%), only one emergency room visit per year (55%), or if their asthma bothers them less than half the time when they exercise (55%). 44% say their asthma is well-controlled if they use a quick-relief medication only three times per week and 38% if they experience symptoms only three days a week.
• 27% of patients believe they do not do everything to reduce the risks associated with asthma.

Patient Beliefs about Asthma Medication

Some asthma patients don’t appreciate the risks involved with stopping a controller medication, and some believe controller usage can be dictated by whether or not they’re feeling symptoms.

• Two in ten asthma patients do not see risks associated with not taking controllers as instructed by their physician (21%) and three in ten do not see risks associated with stopping their controller if they're not experiencing symptoms (29%).
• Most patients (94%) say they know the difference between “quick-relief” medications and controller medications. However, two thirds (69%) agree “quick-relief” medications can be used every day, and four in ten (42%) agree that it is appropriate to take controllers less regularly when symptoms decrease.
• One quarter of all asthma patients (25%) say it is appropriate to stop taking a controller when they are no longer experiencing asthma symptoms.

Patient Usage of Asthma Medication

Although asthma patients profess an understanding of the proper use of controller and rescue medications, reported medication usage doesn't support this understanding. Some patients who have stopped taking their controller medication (n=154)reported serious health consequences as a result.

• Though nine in ten (92%) asthma patients agree that controller medication works best when taken every day, significantly fewer (84%) report taking their controller daily. And of those, only 53% take their controllers every day, at least twice a day.
• Among all patients, close to three in ten (28%) have stopped taking their controller medication.
  • Of those who have stopped taking their controller, seven in ten report they only take it when they have asthma symptoms (71%), or because their asthma is currently under control without the controller medication (70%).
  • Of those who have stopped taking their controller, one in three (34%) report having stopped their controller because their physician said they no longer needed it.
  • Of those who have stopped taking their controller medication, two thirds (65%) have stopped for over one month.
• Notable percentages of patients who have stopped taking their controller have had an asthma attack with considerable repercussions. Two in ten (21%) required treatment with steroid pills, while over ten percent had an emergency doctor visit (17%), serious health consequences (15%), missed work (12%) or went to the emergency room (12%).

Primary Care Physicians‘ Attitudes Toward Asthma

While most physicians recognize the serious nature of asthma and the risks associated with letting it run uncontrolled, a significant percentage of those physicians surveyed (n=300) have misconceptions about the proper use of controller medication.

• Virtually all physicians (98%) believe there are serious risks associated with uncontrolled asthma (16), and most (86%) think that their patients believe the same.
• While nine in ten (92%) asthma patients agree that controllers work best when taken every day, just over eight in ten (83%) physicians predicted their patients would agree.
• Most physicians (78%) believe that the main reason behind the difficulty of explaining the role of inflammation to patients is that airway inflammation isn’t apparent to patients until they're feeling symptoms.
• 89% of patients say their physician instructed them to take their controller every day in accordance with the prescribing information. One in ten said their physician instructed them to take it only as needed for symptoms.
• Slightly more than half (55%) of physicians believe that between 40% and 60% of patients take their controllers as instructed. Only two physicians out of all those interviewed believe 90% or 100% of their patients take their controller as instructed.
• 36% of physicians believe that for patients with moderate to severe asthma it’s appropriate for a patient to take controller medications less regularly, or stop completely, if symptoms subside.

About the Survey

The Asthma G.A.P. Study was conceived and commissioned by the Asthma and Allergy Foundation of America (AAFA) and AstraZeneca and was conducted by Ipsos Public Affairs. Asthma GAP is an extensive national survey assessing awareness and attitudes toward asthma in adults 18 years of age and older and includes the views of a robust, ethnically diverse cross-section of Americans.

The Asthma G.A.P. I study, run in 2007, was an extensive national survey assessing awareness and attitudes toward asthma among American adults. The 2008 GAP II study adds to that original survey more information about perceptions and usage of medication, as well as a detailed account of attitudes of asthma patients who are African-American, Hispanic or residents of six major U.S. metropolitan areas. GAP II also provides new, updated and comprehensive insights on the attitudes of U.S. asthma patients and compares them with attitudes of physicians who treat asthma patients.

Methodology

For the 2008 Asthma G.A.P. II study, “asthma patients” were defined as men and women who reported:

1. Having ever been diagnosed by a health professional with asthma;
2. Still having asthma;
3. Having taken any medication to control their asthma in the past 12 months; and
4. Being at least 18 years of age.

The survey was conducted by telephone between June 27 and August 18, 2008 with a total of 3,664 asthma patients as defined above, including:

• A national sample of 1,001 asthma patients from all ethnicities and regions;
• An additional 436 African-American asthma patients across the United States to complement those from the national sample in order to achieve a total sample of 503;
• An additional 448 Hispanic asthma patients across the United States to complement those from the national sample in order to achieve a total sample of 500; and
• An additional 1,779 asthma patients and residents in six “select metro areas” to complement those from the national sample in order to achieve a total sample of over 300 asthma patients from each of the New York (342), Los Angeles (319), Chicago (318), Dallas-Fort Worth (316), Boston (317) and Atlanta (311) metropolitan areas.

The physicians’ portion of the 2008 Asthma Gap II study consisted of online interviews with 300 primary care physicians (PCPs) including general practitioners, family practitioners, and internal medicine practitioners. In order to qualify for the study, physicians must have been treating at least three asthma patients per week on average. Additionally, they were required to be board-certified or board-eligible.

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