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Scientifica  2013 

Failure in Asthma Control: Reasons and Consequences

DOI: 10.1155/2013/549252

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Abstract:

Clinical research showed that asthma control is an achievable target. However, real-life observations suggest that a significant proportion of patients suffer from symptoms and report lifestyle limitations with a considerable burden on patient’s quality of life. The achievement of asthma control is the result of the interaction among different variables concerning the disease pattern and patients’ and physicians’ knowledge and behaviour. The failure in asthma control can be considered as the result of the complex interaction among different variables, such as the role of guidelines diffusion and implementation, some disease-related factors (i.e., the presence of common comorbidities in asthma such as gastroesophageal reflux disease (GERD), sleep disturbances and obstructive sleep apnea (OSA), and rhinitis) or patient-related factors (i.e., adherence to treatment, alexithymia, and coping strategies). Asthma control may be reached through a tailored treatment plan taking into account the complexity of factors that contribute to achieve and maintain this objective. 1. Introduction Asthma is a disease characterized by chronic inflammation of the airways and associated with airway hyperresponsiveness resulting in episodes of wheezing, chest tightness, shortness of breath, and cough, particularly at night or in the early morning. Asthma is recognized as a highly prevalent health problem affecting an estimated 300 million people of all ages, ethnic groups, and geographic origins, with an additional 100 million people estimated to be affected by 2025 [1]. Asthma incidence rate has been increasing for both male and female adults over time, with higher estimates for women [2]. A review of studies published between 1974 and 2004 reported the incidence of asthma in adults as 3.6 and 4.6 asthma cases per 1000 person-years for men and women, respectively [2]. There is now evidence of a plateau in asthma incidence in pediatric population. The Centres for Disease Control and Prevention documented that although asthma prevalence in childhood increased from 3.6% in 1980 to 7.5% in 1997, the lifetime, current symptom, and asthma attack prevalence remained stable between 1997 and 2007, revealing a plateau [3]. Most recent studies have demonstrated similar results both for adults and for children [4] from different European countries. The presence of asthma is associated with a significant socioeconomic burden [1, 5] due to both direct (such as hospital care, visits, and medications) and indirect costs (such as time lost from work and premature death). Recently, the costs

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