Abstract
Background: Multi-symptom asthma (MSA) can be defined in epidemiological studies and has been shown to reflect severity. It has been uncertain if the definition reflects a more severe disease or is a result of inadequate use of asthma medication. The prevalence of MSA in West Sweden is 2.0%, representing 24% of subjects with physician-diagnosed asthma. The current study aims to determine the use of asthma medication in a group with MSA.
Methods: From a randomly selected population of 18 087 subjects aged 16-75, who participated in a postal survey on respiratory symptoms, a random sample of 2000 was selected for clinical examinations and interview, including questions on use of asthma medication. In addition all remaining subjects (n=1536) reporting asthma were invited. MSA was defined from the questionnaire as reporting physician-diagnosed asthma and reporting use of asthma medication, attacks of shortness of breath and recurrent wheeze and at least one additional respiratory symptom. Asthmatic subjects not having MSA are referred to as “other asthmatics”.
Results: 92% of MSA used asthma medication at the time of the clinical examination, compared with 61% among “other asthmatics”. 71% were on treatment with steroids and 47% used long-acting β2-agonists (either combined with ICS or separately) vs. 40% and 23%, respectively, for “other asthmatics”. Oral steroids were used by 14% and bronchodilators by nebuliser by 6%, 18% used one or both of these.
Conclusion: Subjects with MSA are to a large extent treated with steroids. We conclude that a large majority of multi-symptom asthmatics defined by using a questionnaire have a more severe disease and only a minority does not use maintenance treatment.
- © 2011 ERS