The Journal of Allergy and Clinical Immunology: In Practice
Original ArticleTaking Aim at Asthma Around the World: Global Results of the Asthma Insight and Management Survey in the Asia-Pacific Region, Latin America, Europe, Canada, and the United States
Section snippets
Methods
The AIM study was conducted from 2009 to 2011 in 20 countries in North America, Europe, Latin America, and the AP region. The details of the study designs and methodology have been published previously7, 8, 10, 11 or presented online.12 In the AP region, the original US AIM survey was translated from English to local languages, then back-translated to English, and compared with the original US version. In addition, the survey questions were pretested to increase the confidence that these
Results
Globally, 268,186 households were screened, and a total of 10,302 respondents completed the survey. The mean age of patients in the AP region was 45 years, which ranged from 33 years in Taiwan to 52 years in South Korea.10 In the LA region, the mean age of patients was 37 years, which ranged from 35 years in Venezuela to 43 years in Puerto Rico.11 In the United States, 62% (1555 of 2499) of patients were ≥35 years of age and 38% (944 of 2499) of patients were <35 years of age.15 In the EUCAN
Discussion
The results of this study conducted in more than 10,000 patients with asthma offer a snapshot of real-life asthma management practices across different regions of the world, using 53 questions common to all of the regional surveys. The US and EUCAN surveys also included a question asking patients if their doctor or other health care practitioner ever had them fill out a questionnaire. Patients' acceptance of asthma burden is evident in the global AIM surveys, in which high proportions of
Conclusion
In the AIM surveys, the burden of asthma was evident in the frequency of symptoms, in the episodes of worsening asthma, and more important, by the frequent need for hospital admission or acute intervention. The data from our studies strongly suggest that the level of control of asthma in real life is strikingly lower than the level of control recommended by guidelines.
Although about half of the patients across global regions reported that controller medication should be taken every day, daily
Acknowledgments
Editorial assistance was provided by Ken Kauffman and Patricia Abramo, Adelphi Communications, New York, NY. This assistance was funded by Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc.
References (23)
- et al.
Inadequate use of asthma medication in the United States: results of the Asthma in America national population survey
J Allergy Clin Immunol
(2002) - et al.
Asthma control in the Asia-Pacific region: the Asthma Insights and Reality in Asia-Pacific Study
J Allergy Clin Immunol
(2003) - et al.
Worldwide severity and control of asthma in children and adults: the global Asthma Insights and Reality surveys
J Allergy Clin Immunol
(2004) - et al.
Insights, attitudes, and perceptions about asthma and its treatment: findings from a multinational survey of patients from Latin America
World Allergy Organ J
(2013) - et al.
Development of the Asthma Control Test: a survey for assessing asthma control
J Allergy Clin Immunol
(2004) Medication adherence and persistence as the cornerstone of effective antihypertensive therapy
Am J Hypertens
(2006)- et al.
Real-world Evaluation of Asthma Control and Treatment (REACT): findings from a national Web-based survey
J Allergy Clin Immunol
(2007) - World Health Organization: Asthma: Fact Sheet No. 307, updated November 2013. Available from:...
- et al.
Clinical management of asthma in 1999: the Asthma Insights and Reality in Europe (AIRE) study
Eur Respir J
(2000) - et al.
Asthma control in Latin America: the Asthma Insights and Reality in Latin America (AIRLA) survey
Rev Panam Salud Publica
(2005)
Asthma burden in the United States: results of the 2009 Asthma Insight and Management survey
Allergy Asthma Proc
Cited by (65)
Evaluation of short-acting Beta-2-agonist prescriptions and associated clinical outcomes: Findings from the SABA use IN Asthma (SABINA) study in Asia
2023, World Allergy Organization JournalGlobal burden of asthma associated with high body mass index from 1990 to 2019
2022, Annals of Allergy, Asthma and ImmunologySABA prescriptions and asthma management practices in patients treated by specialists in Taiwan: Results from the SABINA III study
2022, Journal of the Formosan Medical AssociationCitation Excerpt :Interestingly, among patients prescribed ICS/LABA fixed-dose combinations, 47.3% and 41.3% were prescribed low-dose and medium-dose ICS, respectively. While it is encouraging that all patients in Taiwan were presumably prescribed some form of ICS-containing therapy, especially in light of the results from the REcognise Asthma and LInk to Symptoms and Experience (REALISE) Asia, Asthma Insights and Reality (AIR), and Asthma Insight and Management (AIM) surveys indicating that less than one-third of the patients in Asia used daily maintenance medication,32–34 the mean of 4.6 ICS canisters prescribed in the 12 months before the study visit suggests underprescription of ICS. Altogether, 31.6% of patients were prescribed OCS burst treatment, with 86.0% of these patients experiencing ≥1 severe exacerbation in the preceding 12 months.
Rethinking the gold standard – The feasibility of randomized controlled trials within health services effectiveness research
2022, Research in Social and Administrative PharmacyPharmacist-delivered asthma management services—what do patients think?
2022, Journal of the American Pharmacists AssociationCitation Excerpt :The PAS offers a welcome model for pharmacist intervention in asthma care that was rated highly in terms of overall satisfaction, delivery satisfaction, and impact by patients with asthma across a broad range of backgrounds and communities. Innovative ways to engage patients in their asthma care are warranted to alleviate the burden of disease,1 given that approximately 50% of people with asthma remain poorly controlled within the community.2-5 Well-established treatment guidelines and effective medications are available; however, they require patient engagement in self-managing, regular use, and titration in response to fluctuating symptoms.
A questionnaire validated using local treatment guidelines may better predict future asthma risk: MARGIN study
2021, Respiratory Investigation
James E. Fish, MD, was employed by Merck & Co., Inc. when this manuscript was prepared, but he is no longer a Merck employee.
The Asthma Insight and Management surveys were funded by Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc.
Conflicts of interest: R. A. Nathan has received research support from Alcon, Amgen, Array, AstraZeneca, Boehringer Ingelheim, Cephalon, Dyax, Forest, Genentech, GlaxoSmithKline, KaloBios, MAP, MedImmune, Merck, Novartis, Pearl, Rigel, Sanofi Aventis, Shire, Sunovion, Teva, Vectura, and Viropharma; has received consultancy fees from Boehringer Ingelheim, GlaxoSmithKline, Bausch and Lomb, CSL Behring, and Sunovion; and has received speakers' fees from AstraZeneca, GlaxoSmithKline, Merck, and Sunovion. P. J. Thompson has received consultancy fees and travel support from Merck. D. Price has received travel support from Merck; on the boards for Aerocrine, Almirall, Amgen, AstraZeneca, Boehringer Ingelheim, Chiesi, Meda, Mundipharma, Napp, Novartis, and Teva; has received consultancy fees from Almirall, Amgen, AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Meda, Mundipharma, Napp, Novartis, Nycomed, Pfizer, and Teva; has received research support from UK National Health Service, Aerocrine, AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Meda, Merck, Mundipharma, Novartis, Nycomed, Orion, Pfizer, Takeda, Teva, and Zentiva; has received lecture fees from Almirall, AstraZeneca, Boehringer Ingelheim, Chiesi, Cipla, GlaxoSmithKline, Kyorin, Meda, Merck, Mundipharma, Novartis, Pfizer, SkyePharma, Takeda, and Teva; has received payment for manuscript preparation from Mundipharma and Teva; has stock in AKL Ltd.; has received travel support from Aerocrine, Boehringer Ingelheim, Mundipharma, Napp, Novartis, and Teva; has received funding for patient enrollment or completion of research from Almirall, Chiesi, Teva, and Zentiva; and owns 80% of Research in Real Life, Ltd. (and its subsidiary social enterprise Optimum Patient Care), which conducts Contract research for Aerocrine, AKL Ltd., Almirall, Boehringer Ingelheim, Chiesi, Meda, Mundipharma, Napp, Novartis, Orion, Takeda, Zentiva. L. M. Fabbri is on the advisory committee for Forest Laboratories, GlaxoSmithKline, Nycomed, Mundipharma, Grunenthal, Medical Exchan. Inter, Lab Guidotti, and Bayer; is on the advisory board for Dey Pharma; is on the Pearl Therapeutic board; has received consultancy fees from Almirall, Ag Slovena per la ricera, Boehringer, and Boston Scientific; has provided expert testimony for Takead, OM Pharma, MDS, Ferner Group, AstraZeneca, and Kyorin; and receives royalties from Elsevier. J. F. Maspero is on the Novartis board; and has received consultancy fees from Allergy Therapeutics. J. J. Moreno-Cantu is employed by Merck. J. E. Fish is employed by and has stock/stock options from Merck. K. Murphy has received consultancy and lecture fees from Merck, AstraZeneca, Novartis, and Genentech. The rest of the authors declare that they have no relevant conflicts.