Asthma patients' and physicians’ perspectives on the burden and management of asthma

Kenneth R. Chapman, Li An, Sinthia Bosnic-Anticevich, Celeste M. Campomanes, Jerónimo Espinosa, Priya Jain, Kim L. Lavoie, Jing Li, Aman K. Butta

Research output: Contribution to journalArticlepeer-review

23 Citations (Scopus)
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Background: The 2021 Global Initiative for Asthma (GINA) report recommends as-needed inhaled corticosteroid (ICS)/formoterol irrespective of severity, and maintenance and reliever treatment (MART) from GINA Step 3 as part of Treatment Track 1, partly based on the SYGMA studies. We investigated how current clinical practice in Australia, Canada, China and the Philippines relates to latest GINA recommendations. Methods: Patients and physicians were recruited from online panels between July and August 2020 and invited to complete an online survey. Inclusion criteria: age ≥18 years, current/past physician diagnosis of asthma (patients); primary care (Canada also included respirologists/respiratory therapists), treating ≥4 patients with asthma per month, ≥3 years in clinical practice (physicians). Results: Overall, 1216/70,183 patients and 803/8376 physicians replied and were eligible for inclusion. Only 8–15% of patients were using MART; 66–81% used regular maintenance therapy with/without an as-needed reliever. Across the four countries, physicians classified 48–63% of their patients as mild (GINA Steps 1–2) and 28–36% as moderate (GINA Steps 3–4). Generally, physicians rated symptom control over exacerbation reduction as their main treatment goal; patients also ranked symptom relief as very important. Approximately 9–29% of patients and 24–45% of physicians were unaware of MART, and among those who prescribed MART, 80–95% prescribed an additional (non-ICS) as-needed reliever. Interpretation: Most physicians prioritized managing asthma symptoms over exacerbations. A lack of awareness and understanding of MART dosing exists among physicians. Practical strategies are required to implement GINA recommendations effectively in real-world clinical practice and to identify appropriate patients for MART.

Original languageEnglish
Article number106524
Pages (from-to)1-10
Number of pages10
JournalRespiratory Medicine
Publication statusPublished - Sept 2021
Externally publishedYes

Bibliographical note

Copyright the Author(s) 2021. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.


  • 3–6): Asthma symptoms
  • GINA
  • Global cohort
  • Guideline adherence
  • Patient perspectives
  • Physician perspectives


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