Many asthmatic stop taking medicine or skip doses, and those who do take their medication rarely discuss the side effects with a doctor, according to a large international survey.

The problem may be due to poor doctor-patient communication.

Survey Results

The findings, from the Global Asthma Physician and Patient (GAPP) survey, involved nearly 3,500 adults in 16 countries. The results point out just how serious the communication gaps between doctor and patient can be.

An overwhelming majority of asthma patients-73%-said they never or rarely discuss medication side effects with their physicians.

Although nearly 20% said they are not aware of short-term side effects of medication, only 5% of the physicians who prescribe these drugs said that they think patients don't know about these possible side effects.

"The data in the United States show that doctors don't seem to be spending as much time as they should with asthma patients," says survey team member Dr. Michael A. Kaliner, of the Institute for Asthma & Allergy.

Because asthma is a chronic disease, successfully controlling it takes commitment by both patients and their health-care providers, he says. However, when physicians are under pressure to see many patients in a relatively short time period, as is the case in some health maintenance organizations (HMOs), conversations about asthma c re may be rushed or incomplete, he notes.

Action Plans

National guidelines for asthma management call for treatment plans that are written, discussed and provided by the doctor in partnership with the patient. However, some studies have shown that these written plans are often absent.

In one study of more than 500 asthma patients who came to the emergency room, less than 10% had action plans for dealing with their asthma. "We gave them the plans once they came to the emergency department," notes one of the lead investigators, Dr. Loren Yamamoto, professor of pediatrics at the University of Hawaii.

However, doing this was so time-consuming that an extra staff person was needed, Yamamoto says. After the study was completed, that staff member could no longer be funded.

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