Background

Combination low-dose budesonide-formoterol, taken as-needed for symptom relief reduces exacerbation risk and is recommended for treatment of mild asthma. The NovelQ qualitative study explored patients’ attitudes toward using this novel therapy.

Methods

Adults with mild asthma using reliever-only treatment were randomised to as-needed budesonide-formoterol Turbuhaler® in a multinational, 52-week open-label randomised controlled trial (NovelSTART-ACTRN12615000999538). A subgroup were interviewed to explore their attitudes to use of as-needed budesonide-formoterol after receiving it for ≥10 months. Semi-structured interviews were conducted until saturation, audio-recorded, and thematically analysed.

Results

Analysis of 35 participants (66% female; mean age 43.5 [range 18–74]; mean Asthma Control Questionnaire score 1.09 ± SD0.55) interviews identified 5 themes, each including both barriers and facilitators to therapy use. Themes were: ‘Treatment effectiveness’ i.e. how well symptoms were relieved and/or prevented; ‘Lifestyle fit of the regimen’ e.g. the extent to which the treatment regimen integrated into the patient's daily life; ‘Attitudes toward medication use and safety’ e.g. openness for new reliever treatments, beliefs about treatment necessity or side effects; ‘Device attributes’ e.g. perceived ease of use; and ‘Doctor-patient relationship’ e.g. impact of health professional support on new treatment acceptance.

Conclusions

A wide range of factors seem to drive the opinions of mild asthma patients on as-needed budesonide-formoterol therapy. Many patients perceived both positive and negative treatment attributes, and their individual evaluation of these attributes determined their likelihood of using it after the study. Supportive patient-physician interactions appear key to addressing patient barriers. Recommendations for patient-centred discussions, developed from this research, are provided.

中文翻译：

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Turbuhaler®按需布地奈德-福莫特罗治疗轻度哮喘的患者经验；定性研究

背景

根据需要服用低剂量布地奈德-福莫特罗组合来缓解症状可降低恶化风险，推荐用于治疗轻度哮喘。NovelQ 定性研究探讨了患者对使用这种新型疗法的态度。

方法

在一项为期 52 周的多国开放标签随机对照试验 (NovelSTART-ACTRN12615000999538) 中，仅使用缓解剂治疗的轻度哮喘成人被随机分配至按需布地奈德-福莫特罗 Turbuhaler®。对一个亚组进行了访谈，以探讨他们在接受 10 个月以上按需使用布地奈德福莫特罗后的态度。半结构化访谈进行到饱和、录音和主题分析。

结果

对 35 名参与者（66% 女性；平均年龄 43.5 [范围 18-74]；哮喘控制问卷平均得分 1.09 ± SD0.55）的分析确定了 5 个主题，每个主题都包括使用治疗的障碍和促进因素。主题是：“治疗效果”，即症状的缓解和/或预防效果；“治疗方案的生活方式适合度”，例如治疗方案融入患者日常生活的程度；“对药物使用和安全的态度”，例如对新的缓解治疗持开放态度，对治疗必要性或副作用的看法；“设备属性”，例如感知的易用性；和“医患关系” 例如，健康专业支持对新治疗接受度的影响。

结论

广泛的因素似乎推动了轻度哮喘患者对按需布地奈德-福莫特罗治疗的看法。许多患者感知到积极和消极的治疗属性，他们对这些属性的个人评估决定了他们在研究后使用它的可能性。支持性的医患互动似乎是解决患者障碍的关键。提供了根据本研究制定的以患者为中心的讨论建议。