Asthma Control and Concordance of Opinions Between Patients and Pulmonologists.

J Asthma. 2013 Jul 1 Urrutia I, Plaza V, Pascual S, Cisneros C, Entrenas LM, Luengo MT, Caballero F. Pulmonology Department, Galdakao Hospital, Vizcaya, Spain. Patient-physician opinion concordance could play a key role in asthma control. There have been no studies evaluating this association in large samples of patients.

Objectives: To determine opinion concordance between asthma patients and their pulmonologists on the impact of the disease and to correlate concordance to asthma control.

Methods: This was a cross-sectional multicentre study including 1,160 patients and 300 pulmonologists. Patient-physician concordance rates were assessed by two semi-structured qualitative questionnaires: 1) impact of the disease 2) treatment satisfaction. Subsequently, participating pulmonologists determined the concordance between their perceptions and their patient's. Sociodemographic and clinical data were recorded for all patients.

Results: In 53.6% of cases, asthma was controlled. The rate of patient-pulmonologist concordance on disease impact on patient daily life was 57%, with physicians underestimating the impact (compared to patients) in 26% of cases. Concordance on satisfaction with treatment was 56%, with physicians underestimating satisfaction in 26% of cases. Patient-physician discordance rates were significantly lower among patients with controlled asthma (29 and 32.1%) than those with poor control (73.7 and 73.1%).

Conclusions: Patient-pulmonologist concordance on perceptions of disease impact is low, particularly in uncontrolled asthma. This poor concordance should be addressed in education programmes, particularly for patients with uncontrolled symptoms.

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