There is a huge difference in how well asthmatics believe their symptoms are being controlled and how well they are actually managing their disease according to experts.

"'We have known for a long time that asthma can be controlled better, that it is not being controlled as well as it can be, and that we ought to do something about it," explains Dr. Norman Edelman, a professor of medicine at the State University of New York at Stony Brook and a medical consultant to the American Lung Association. Improving symptom control means that asthmatics must first recognize that they are not being controlled as well as they could be.

Poll Results

A recent poll taken by the Asthma and Allergy Foundation of America (AAFA) found that 88% of nearly 600 adult asthmatics reported managing their symptoms well.

However, in that same group, 61% said they have had to catch their breath while running up the stairs, 48% said their asthma symptoms have woken them and 50% have had to stop exercising in the middle of their regimens.

Among 118 respondents whose children have asthma, 89% felt their children's symptoms were being well-controlled, yet half of the children had missed days of school and/or work. In addition, half were unable to complete their exercise programs and 45% were awakened because of asthma symptoms.

Perception Vs. Reality

"This was an interesting study of perception versus reality," says Mike Tringale, AAFAs director of communications. "These people have learned to live with compromised lives."

He adds, "Now, however, because of better understanding of the disease, better preventive education and better medicines, most people with asthma don't have to have any symptoms."

Poorly managed asthma can lead to numerous health problems, including weight gain from not exercising. "Weight gain is terrible for asthma, because it exacerbates the symptoms," he says.

There are also more subtle psychological changes. "People's personalities are affected. Even though you are going about your daily activities, like going to work, you are still disabled because you are not functioning at your maximum. It changes who you are," Edelman says.

Closing The Knowledge Gap

To close the knowledge gap, both the American Lung Association and AAFA have started programs to alert people who have asthma that most can control their symptoms more effectively.

The American Lung Association introduced a five-question test on its Web site for asthmatics older than age 12. The questions ask how often asthma symptoms keep them awake at night, cause shortness of breath and prevent them from completing work at school or in the office.

"Approximately 100,000 people have taken the test online, and two-thirds of them have found that they don't have their asthma under control," says Edelman.

The test's success has spurred the Association to develop another quiz designed for children under age 12, to be answered by their parents.

The AAFAs program, called Sleep Work Play, helps asthma patients better recognize their symptoms so they can talk to their doctors about controlling them more effectively.

AAFAs program includes a Web site questionnaire that asks asthma patients about their sleep, work and play habits. It also encourages users to take the completed questionnaire to their doctor to discuss how to better manage their asthma symptoms.

"People haven't been talking in the same language. Doctors don't probe deeply enough into patients' symptoms; parents don't question their kids," says Tringale.

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