Repeated cross-sectional survey of patient-reported asthma control in Europe in the past 5 years.

Although the main goal of asthma management guidelines is to achieve and maintain clinical control, reported levels of not well-controlled asthma remain high. The aim of this analysis was to compare the levels of asthma control and the associated impact on patients' health status in Europe in 2006, 2008 and 2010. An additional outcome was the comparison of the burden of asthma with diabetes. Data were obtained from the cross-sectional, self-reported, European National Health and Wellness Surveys conducted in France, Germany, Italy, Spain and the UK. Asthma control (Asthma Control Test™; QualityMetric, Inc., Lincoln, RI, USA) and health status (Short Form (SF)-12 health survey and the Work Productivity Loss and Activity Impairment questionnaire) were assessed. In 2010, the proportion of treated asthma patients assessed as having not well-controlled asthma was 53.5%, compared with 56.6% and 55.0% in 2008 and 2006, respectively. A significant reduction in not well-controlled asthma was observed in Germany between 2006 (72.3%) and 2010 (62.5%; p=0.005). Fluctuations in control levels were observed in other countries. For all surveys, having at least well-controlled asthma was associated with a significantly lower number of healthcare contacts in the previous 6 months, better mean±(SD) SF-12 scores for the physical (data for 2010: not well controlled 39.9±11.38, at least well-controlled 48.0±9.89; p<0.001) and mental (data for 2010: not well-controlled 40.6±10.95, at least well-controlled 45.0±10.91; p<0.001) components, and significantly less impact on Work Productivity Loss and Activity Impairment. Asthma and diabetes were associated with a similar overall negative impact on health status. A substantial proportion of asthmatics remain not well-controlled across five European countries, resulting in a significant impact on health resources and patients' health status. The overall burden of asthma appears to be similar to that of diabetes.

Update on asthma control in five European countries: results of a 2008 survey.

The 2006 European National Health and Wellness Survey (NHWS) showed that a large proportion of asthmatics had uncontrolled asthma. The current analysis estimated the prevalence of asthma and asthma control (Asthma Control Test™ (ACT); QualityMetric Inc., Lincoln, RI, USA) in five European countries using the 2008 NHWS. Health-related quality of life (HRQoL), using the Short Form-12 (SF-12) health survey, and work productivity/activity impairment were assessed. Of 3,619 respondents aged ≥18 yrs, the prevalence of self-reported physician diagnosis of asthma was 6.1% (15 million people); 56.6% of treated asthmatics were not well-controlled (NWC; ACT score ≤19). Individual components of the ACT showed that, compared with at least well-controlled patients (ALWC; ACT score ≥20), NWC patients had activity limitations at least some of the time (40.8% versus 1.5%, p<0.001), were breathless ≥3 times per week (72.5% versus 5.4%, p<0.001), suffered sleep difficulties due to asthma at least once per week (60.3% versus 4.6%, p<0.001) and required rescue medication ≥2-3 times per week (77.4% versus 15.9%, p<0.001). NWC patients had also received more healthcare contact in the past 6 ;months, including hospitalisation (17.4% versus 9.9%, p<0.001). The SF-12 physical and mental summary scores were 7.46 and 4.73 points higher, respectively, for ALWC patients compared with NWC patients (p<0.001). ALWC patients reported less absenteeism (5.5% versus 12.2%) and work impairment (15.4% versus 30.0%) than NWC patients (both p<0.001). The proportion of asthmatics with NWC asthma has not improved since 2006. ALWC asthma is associated with a significant positive impact on healthcare resource use, HRQoL and work productivity.