Key barriers to optimal manage­ment of adult asthma in Australia: physician and patient perspectives

ABSTRACT Objective: Despite recent advances in asthma treatment, its management in many patients remains sub-optimal. The aim of the Global Asthma Physicians and Patient (GAPP) survey was to identify barriers to optimal asthma management and to explore the content and dynamics of physician–patient communications. Here we present the key findings for adults with asthma in Australia. Research design and methods: Patients with asthma aged ≥ 18 years and physicians who treat adults (generalists; specialists) participated in telephone interviews conducted in May–June 2005, using close-end questionnaires. The survey examined physicians’ beliefs and prescribing habits; patients’ experiences with asthma; doctor–patient communication; satisfaction with asthma medications and interest in new asthma treatment. Results: A total of 101 adults with asthma and 100 physicians treating asthma patients in Australia completed the survey. Overall, key barriers to optimal asthma management included medication side effects, treatment compliance and patient education. These barriers may be exacerbated by poor patient–physician communication that fails to address patients concerns regarding side effects and may lead to poor treatment compliance. Both physicians and patients expressed safety concerns regarding the long-term use of inhaled corticosteroid and both groups would welcome new treatment options with improved safety profiles, efficacy and once-daily dosing. Conclusion: From both a physician and patient perspective, the safety profile of asthma medication constitutes a key factor in promoting treatment compliance and, ultimately, treatment outcomes. The results highlight discrepancies in perceived patient–physician communication and a need for improved patient education in asthma management.