Abstract

Background: One of the most commonly observed asthma treatment patterns is the underuse of inhaled corticosteroid (ICS) maintenance therapy when patients are not experiencing symptoms, and the predominant use of short-acting β2-agonists (SABAs) when patients are experiencing symptoms. This multinational study investigated the current beliefs and behaviors related to reliance on reliever inhalers among asthma patients, and the reasons why patients may not adhere to their recommended maintenance controller treatment.

Methods: This was a qualitative research study, in which 80 patients with asthma who were receiving reliever therapy (i.e. SABAs) were interviewed, in-depth, for 60 min. The interview questions focused on the patients’ experience of living with asthma and their inhaled treatment regimens.

Results: The key insights identified in the interviews were (a) patients had a strong emotional attachment to SABA relievers driven by their efficacy and success in quickly alleviating asthma symptoms, with the reliever also becoming an emotional support; (b) patients typically did not understand that the frequent use of SABAs indicates poor asthma control; (c) patients had a misperception of ICS, which could lead to a delay in escalation and poor adherence; and (d) severe exacerbations improve adherence to ICS, but only temporarily in many cases.

Conclusion: This study confirmed the poor level of control patients have over their asthma, and how this affects their lifestyle and daily activities. Our results also confirmed that the patients’ perception of both the disease and treatment plays a key role in SABA reliance and ICS underuse.

摘要

背景：最常见的哮喘治疗方式之一是当患者没有症状时未充分使用吸入糖皮质激素（ICS）维持疗法，而在患者出现症状时主要使用短效β2-激动剂（SABA）。这项跨国研究调查了哮喘患者中目前依赖于缓解吸入器的信念和行为，以及患者可能不遵循推荐的维持控制者治疗的原因。

方法：这是一项定性研究，其中对80例接受缓解治疗（SABA）的哮喘患者进行了深度访谈，时间为60分钟。访谈问题集中于患者的哮喘病生存经验及其吸入治疗方案。

结果：访谈中发现的主要见解是：（a）患者对SABA缓解剂有强烈的情感依恋，这是由于其在快速缓解哮喘症状方面的功效和成功所致，而缓解剂也成为情感支持；（b）患者通常不了解频繁使用SABA表示哮喘控制不佳；（c）患者对ICS有误解，可能会导致升级升级和依从性差；（d）严重病情恶化可提高对ICS的依从性，但在许多情况下只是暂时的。

结论：这项研究证实了控制哮喘患者的哮喘水平很差，这如何影响他们的生活方式和日常活动。我们的结果还证实，患者对疾病和治疗的感知在SABA依赖和ICS使用不足中起关键作用。