The CASE Survey: Patient and Physician Perceptions Regarding Asthma Medication Use and Associated Oropharyngeal Symptoms

Overview

Journal Can Respir J

Publisher Wiley

Specialty Pulmonary Medicine

Date 2008 Feb 23

PMID 18292850

Citations 1

Authors

J M Fitzgerald

C Kn Chan

M C Holroyde

Louis-Philippe Boulet

Affiliations

Soon will be listed here.

Abstract

Background: Oropharyngeal (OP) symptoms are common in asthma patients using inhaled corticosteroids (ICSs) alone and in combination with a long-acting beta(2)-agonist (LABA). Patterns of medication use, level of asthma control and association with OP symptoms are not often reported in a nonstudy setting.

Objectives: To determine the prevalence of OP symptoms among adult asthma patients using ICSs alone and an ICS plus a LABA; to investigate the relationships between medication use, asthma control and OP symptoms; and to assess family physicians' (FPs') perceptions of the prevalence and management of OP symptoms.

Methods: A random telephone survey of 1003 asthma patients and 250 FPs treating asthma patients was conducted from February to March 2005 across Canada.

Results: Twenty-four per cent of patients experienced OP symptoms; 67% of them spoke to their FPs about the OP symptoms. Thirty-one per cent of patients who experienced OP symptoms stopped or reduced their dose of medication. OP symptoms were reported by 25% of patients using ICSs and 22% using an ICS plus a LABA. The incidence of OP symptoms was not affected by the choice of inhalation device (metered-dose inhaler versus dry powder inhaler) or the use of a spacer. Fifty-eight per cent of patients had uncontrolled asthma; patients achieving a lower level of general education were more likely to have poor control. Patients with uncontrolled asthma were more likely than those with controlled asthma to report OP symptoms (28% versus 18%, respectively; P<0.05). Eighty-nine per cent of FPs had patients who had reported OP symptoms to them. FPs estimated that 15% of their patients experienced OP symptoms and that compliance to treatment worsened in approximately 20% of them.

Conclusions: The prevalence of OP symptoms in asthma patients using ICSs and an ICS plus a LABA is significant. OP symptoms were found to be associated with a reduced patient education level, with a likelihood of reducing or stopping medication, and with a less well-controlled asthma patient. While FPs recognized that a significant proportion of their asthma patients experience OP symptoms and that OP symptoms may affect compliance, they underestimated the prevalence of this problem.

Citing Articles

Local adverse effects associated with the use of inhaled corticosteroids in patients with moderate or severe asthma.

Pinto C, Almeida N, Marques T, Yamamura L, Costa L, Souza-Machado A J Bras Pneumol. 2013; 39(4):409-17.

PMID: 24068261 PMC: 4075864. DOI: 10.1590/S1806-37132013000400003.

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