Printable Version of Global Pediatric Findings (pdf)

Authors:
Erkka Juhani Valovirta (1), Carlos E. Baena-Cagnani (2), Michael S. Blaiss (3), G. Walter Canonica (4), Michael A. Kaliner (5), Ronald Dahl (6)

Author Affiliation:

1. Turku Allergy Center, Turku, Finland, for the World Allergy Organization
2. Catholic University of Córdoba, Córdoba, Argentina, for the World Allergy Organization
3. University of Tennessee Health Science Center, Memphis, TN, USA, for the American College of Allergy, Asthma & Immunology
4. University of Genova DIMI, Genova, Italy, for the World Allergy Organization
5. Institute for Asthma & Allergy, Chevy Chase, MD, USA, for the World Allergy Organization
6. Aarhus University Hospital, Department of Respiratory Diseases, Aarhus, Denmark, for the World Allergy Organization

Background
The GAPP Survey is the first-ever global quantitative survey designed to uncover asthma attitudes and treatment practices among physicians and patients, with the goal of identifying barriers to optimal management.

Methods
5,482 interviews were conducted globally online, by telephone and face-to-face: 1,733 physicians and 1,726 asthma patients in a 16-country adult arm; 1,006 physicians treating children with asthma and 1,017 parents of children with asthma patients in a 9-country pediatric arm.

Results
Parents of children with asthma report that physicians do not discuss various asthma-related issues, such a plan for treating asthma, correct inhaler technique and relationship between allergies and asthma as frequently as physicians say they do. Overall, parents are more concerned than physicians about side effects. Most parents report physicians are not initiating the discussion about side effects and more than half of parents report rarely or never having the discussions at all. Parents who say their child has taken medication report that 26% have experienced short-term side effects and 10% have experienced long-term side effects. Of parents who say their child has experienced side effects, 33% have considered switching medications and 30% skipping doses. 41% of parents say their child does not take his/her medication according to physician’s instructions 100% of the time; physicians, on average, say their average patient takes medication according to physician instructions 68% of the time. 77% of patients who are not compliant all of the time experience at least one of the following including, increased symptoms (66%), limited physical activity (48%), nighttime awakenings (46%), more frequent attacks or exacerbations (40%), more physician visits (38%), absences from school (32%). 80% of parents believe there is a need for a new treatment, and those parents are more likely to report decreased quality of life (more ER visits, limited activities – parents and child); 84% of physicians would welcome new treatment options.

Conclusions
Compliance is low and according to parents, experience with side effects appears to be an important factor; compliance appears directly linked to an increased symptomatology and resource utilization. In addition, the availability of new ICS treatment options with comparable efficacy and improved safety and tolerability might enhance patient outcomes.