In the last 15 years the prevalence of asthma has increased by approximately 3.6%. The aftermath of covid-19 has left many vulnerable, with 56% of survey respondents stating that the pandemic has made managing their asthma more challenging. Just as health systems are trying to recuperate and on much leaner budgets, climate change is adding further stress. There urgently needs to be a coordinated global response to better manage the condition.
Poorly controlled asthma has a much higher economic burden than well managed asthma. Adults with frequent asthma exacerbations need more hospital care, and so are experiencing missed workdays and productivity losses at a higher rate (average 13 days a year). Compare that to those with controlled asthma, for whom these rates are similar to that of healthy people.
The FUture of RespiraTory HEalth Readiness (FURTHER) Initiative is a globally relevant effort to address important questions on the future landscape of chronic respiratory disease. Every breath you take: Taking the patient voice FURTHER in their asthma journey is a report that focuses on asthma, launching today at the ERS International Congress 2022. The report highlights a persistent problem in getting consistent, high-quality care and solutions for respiratory issues, one of the most prevalent and economically damaging non-communicable diseases in the world.
Economist Impact carried out a survey of asthma patients spanning 13 countries , looking at how they perceived their current treatment, as well as what hope they had for future care.
Key findings from the patient survey:
- More than 20% of respondents had been admitted twice to hospital for an asthma-related reason
- Less than 50% of respondents were satisfied with their current asthma treatment plan, or felt that their condition was well managed
- Around 30% of patients claimed they did not adhere to their prescribed treatment due to financial constraints
- 74% wished there was better asthma patient education in their community
- More than a third of respondents expressed an interest in environmentally-friendly treatment options such as green inhalers
There is no gold standard for asthma diagnosis, and treatment options and approaches can vary. This survey highlights some of the needs and gaps along a patient’s asthma journey that still exist, and warrant continued efforts to improve asthma care.
Alongside the survey, the FURTHER initiative brought together experts from across the scientific, medical and patient community to deliberate and discuss the current state of asthma care and establish four actionable recommendations to benefit patients globally.
1. Educate patients so they can help themselves
It is estimated 70-90% of people using asthma inhalers make mistakes with use. The panel reported that a lack of patient education is an influential factor in the mismanagement of asthma globally. It is crucial to ensure better education for asthma patients so that they have a better understanding of their disease, its triggers and its treatment. Together with HCPs, patients can then truly participate in their care and find a plan that will work best for them. Patient empowerment ensures that patient voices are valued and treatment plans can be adhered to. It is not about patients having decision-making autonomy on when to take their medication or react to symptoms, but about equipping them with the resources and tools to better understand and manage their condition.
2. Giving clear, simple guidelines for HCPs globally
The expert panel agreed that adherence to both national and global guidelines in practice was alarmingly poor, for example, one study revealing that only 40% of physicians in Hong Kong followed guidelines for prescribing and assessing asthma control. This is due, in part, to current guidelines not being accessible, financially viable, concise, or practical enough for most physicians. Better education for physicians around asthma is required to enable asthma to be diagnosed as early as possible, as well as ensuring accurate prescription and treatment recommendations for patients living with asthma. Training in concepts around motivational communication can enable physicians to better understand patient needs and reasons for poor adherence, and tailor information and advice accordingly.
3. Diversity in clinical and patient care guidelines
The direction and focus of guidelines is often dictated by a core group of experts and specialists and rely heavily on data from randomised clinical trials. As a result, guidelines are often not patient friendly, or well perceived or adopted by the wider asthma community. The process of guideline development and dissemination should ideally involve regular communication and interaction between specialists, GPs and patients to assess their values and needs.
4. A renewed focus on holistic, personalised asthma care
Given the complexity of asthma, and the further complications that comorbidities could have on its management, it is essential that treatment decisions adopt a holistic, multidisciplinary, patient-centric approach to care. Consistent, preventive and proactive treatment is a cornerstone of asthma management and changing patient behaviour to optimise control of risk factors is key. The use of personalised asthma action plans (PAAPs) can ensure that better asthma control and quality of life is achievable through consideration of the individual complexities and context that may impact the management of asthma on a case by case basis.
Commenting on the report, Rob Cook, Clinical Director, Health Policy and insights at Economist Impact, said: “There have been a lot of advances in the treatment of asthma, many of which have dramatically improved the quality of life of patients. Nevertheless, with external factors exacerbating symptoms, it is our duty to keep striving for better care. By examining global standards and guidelines, we can push for the future of medicine – personalised care plans. As new and greener technologies come to market, it is an exciting time to re-structure patient advocacy on a global scale.”
To read the full report, go to thefurtherinitiative.com