Asthma in Asia: Physician perspectives on control, inhaler use and patient communications

David Price, Aileen David-Wang, Sang-Heon Cho, James Chung-Man Ho, Jae-Won Jeong, Chong-Kin Liam, Jiangtao Lin, Abdul Razak Muttalif, Diahn-Warng Perng, Tze-Lee Tan, Faisal Yunus, Glenn Neira, REcognise Asthma and LInk to Symptoms and Experience (REALISE) Asia Working Group

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OBJECTIVE: We examined the physician perspectives on asthma management in Asia.

METHODS: An online/face-to-face, questionnaire-based survey of respiratory specialists and primary care physicians from eight Asian countries/region was carried out. The survey explored asthma control, inhaler selection, technique and use; physician-patient communications and asthma education. Inclusion criteria were >50% of practice time spent on direct patient care; and treated ≥30 patients with asthma per month, of which >60% were aged ≥12 years.

RESULTS: REALISE Asia (Phase 2) involved 375 physicians with average 15.9(±6.8) years of clinical experience. 89.1% of physicians reporting use of guidelines estimated that 53.2% of their patients have well-controlled (GINA-defined) asthma. Top consideration for inhaler choice was asthma severity (82.4%) and lowest, socio-economic status (32.5%). 54.7% of physicians checked their patients' inhaler techniques during consultations but 28.2(±19.1)% of patients were using their inhalers incorrectly. 21.1-57.9% of physicians could spot improper inhaler techniques in video demonstrations. 79.6% of physicians believed combination inhalers could increase adherence because of convenience (53.7%), efficacy (52.7%) and usability (18.9%). Initial and follow-up consultations took 16.8(±8.4) and 9.2(±5.3) minutes respectively. Most (85.1%) physicians used verbal conversations and least (24.5%), video demonstrations of inhaler use. 56.8% agreed that patient attitudes influenced their treatment approach.

CONCLUSION: Physicians and patients have different views of 'well-controlled' asthma. While physicians informed patients about asthma and inhaler usage, they overestimated actual usage and patients' knowledge was sub-optimal. Physician-patient interactions can be augmented with understanding of patient attitudes, visual aids and ancillary support to perform physical demonstrations to improve treatment outcomes.

Original languageEnglish
Pages (from-to)761-769
Number of pages9
JournalJournal of Asthma
Issue number7
Early online date17 May 2016
Publication statusPublished - 2016


  • Physician-patient communications
  • education
  • inhaler techniques
  • attitudes


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