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Patient Perceptions of Living with Severe Asthma: Challenges to Effective Management.

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posted on 2019-07-08, 15:42 authored by LD Apps, S Chantrell, S Majd, E Eglinton, SJ Singh, AC Murphy, P Bradding, RH Green, N Hudson, RA Evans
BACKGROUND: The management of severe asthma poses many challenges related to treatment, adherence, and psychosocial morbidity. There is little direct data from the patient perspective to understand and negotiate the complexities of managing severe asthma. OBJECTIVE: To explore the patient perceptions of living with severe asthma and the experience of managing severe asthma, in order to better understand the support that might promote more effective self-management for severe asthma. METHODS: Participants were recruited from a specialist Difficult Asthma Service. Semistructured interviews were conducted by researchers independent of the patient's care. Interviews were transcribed verbatim and inductive thematic analysis was performed. RESULTS: Twenty-nine participants (13 male: mean [standard deviation] age, 49.5 [13.6] years: mean Asthma Control Questionnaire 2.2 [1.2]) participated in an interview. Analysis resulted in 4 major themes describing the experience and challenges to managing severe asthma: understanding of severe asthma, emotional impact of living with severe asthma (subtheme: fear of hospitalization), public perceptions of asthma, and concerns about medications. CONCLUSIONS: Health care professionals need to consider and discuss with patients their perceptions of severe asthma and the relevant treatments; particular attention should focus around education of disease control and actively exploring thoughts around hospitalization. Our data highlight the potential for psychological and social support to enhance self-management by directly addressing the wide-ranging individual challenges patients face. There is also a need for greater public awareness and education about severe asthma to minimize patient distress particularly in the work environment.


This research was supported by a research grant from the National Institute for Health Research (NIHR): Research for Patient Benefit Programme (PB-PG-0712-28063) . The funder had no role in the design of the study, data collection, analysis and interpretation or writing of the report, and decision to submit for publication. R. A. Evans holds an NIHR clinical scientist fellowship CS-2016-16-020. The views expressed in this article are those of the author(s) and not necessarily those of the National Health Service, the NIHR, or the Department of Health and Social Care.



Journal of Allergy and Clinical Immunology: In Practice, 2019

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/Organisation/COLLEGE OF LIFE SCIENCES/School of Medicine/Department of Infection, Immunity and Inflammation


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