Perceptions, impact and management of asthma in South Africa: a patient questionnaire study

INTRODUCTION: A number of studies from around the world have indicated that asthma morbidity is still unacceptably high. In the AIRE study over one-third of children and half of the adults reported daytime symptoms at least once a week. This study was conducted to understand the impact (including the impact on health-related quality of life) of asthma on South African asthmatics. MATERIALS AND METHODS: General Practitioners (GPs) and pharmacists in South Africa were randomly identified from the Medical Association database. These individuals were approached and asked to recruit asthmatic patients to complete a questionnaire. The questionnaire inquired about symptoms, quality of life, complications, trigger factors, associated allergic conditions, medication used, medication preference, medication adherence and concerns about the condition. RESULTS: 3347 respondents returned their demographic data but only 710 met the criteria for analysis, ie. had asthma and were presently on controller medication. Symptom analysis revealed that 21.4% of respondents were coughing on most days, 25.6% were wheezing on most days, and 22.8% were experiencing night-time symptoms on most days. Symptoms were exacerbated by exercise in 56.9%, while nocturnal wakening due to asthma occurred in 36.9% more than four times per week. Only 35.1% of respondents had not missed school or work in the preceding year. 45.4% of individuals worry about side effects of asthma therapy. CONCLUSION: This study indicates that there is under-treatment, inappropriate treatment and/or lack of patient education for asthma patients in South Africa. The data support the notion that poor therapy and/or poor patient adherence has an enormous impact on the health-related quality of life of South Africa's asthmatics.