Published Online: June 23, 2015
Asthma is a major and growing public health problem across the world. The Asthma Insight and Management (AIM) survey, the largest survey of adults and adolescents with asthma conducted since 2001, reveals numerous unmet needs with regard to the current state of asthma care and overall patient expectations. The authors examined the similarities and differences in AIM survey findings from the Asia-Pacific region, Latin America, Europe, Canada, and the United States. Although AIM survey results from each of these regions have been published individually, this examination offers insight into the differences and similarities across the globe.
This paper by Nathan et al in The Journal of Allergy and Clinical Immunology: In Practice covers findings from the AIM survey conducted in 20 countries around the world from 2009 to 2011. Screening for survey respondents identified households in which at least one adult or adolescent had physician-diagnosed asthma and experienced symptoms or used asthma treatment during the previous year. Interviews of patients with asthma or parents of adolescents with asthma were conducted either by telephone or face-to-face, depending on the country.
A total of 10,302 respondents from 20 countries completed the AIM survey. Over 10% of respondents reported having symptoms nearly every day or night over the previous four weeks, and approximately half of respondents reported episodes in the previous year when their asthma symptoms were more frequent or more severe than normal. From 21% to 44% of respondents reported an unscheduled or emergency visit for treatment of asthma in the previous year. At least 46% of patients reported that they used controller medication over the previous four weeks. Reported use of oral steroids over the previous year to manage asthma symptoms was highly variable, ranging from 21% to 89% of respondents. Overall, from one-third to two-thirds of respondents reported use of quick-relief medication at least once a week over the previous year. Two-thirds of patients considered their asthma to be well controlled, but less than 10% had well-controlled asthma based on asthma management guidelines. Furthermore, great variability exists globally in methods doctors use to assess asthma. Patients also reported an acceptable frequency of asthma exacerbations that was discordant with asthma guidelines. In addition, survey responses indicate that patients have different attitudes about asthma burden and medication use.
The AIM survey results show similarities around the world in patients’ acceptance of asthma burden, their low expectations of asthma management, and their lack of knowledge and conviction regarding asthma treatment goals and recommendations. In contrast, greater variability exists in patients’ asthma medication use and perceptions of their asthma control. The survey revealed disagreement between physician recommendations and patient choices regarding the use of controller medications. Compared to prior survey results, the AIM survey results suggest that asthma management has not changed much over the past 10 years, and improvements in asthma control are still needed.
The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.