Abstract
IntroductionThe impact of asthma and chronic obstructive pulmonary disease (COPD) on individuals’ lives may be substantial, yet clinical practice often focuses only on symptoms. We aimed to better understand the perspective of asthma or COPD patients and to identify condition-related burden, life impact, priorities, unmet needs, and treatment goals.MethodsIndividuals aged at least 18 years with asthma or COPD were identified by a recruitment panel via clinical referrals, support groups, consumer networks, and a patient database. Interviews were carried out individually (by telephone) or in focus groups (with no more than five participants per group). A semi-structured interview guide was used with prespecified topics, informed by a literature review, that were considered impactful in asthma or COPD (symptoms and daily-life impact, satisfaction with current treatment, important aspects of treatment, adherence, and ideal treatment).ResultsOverall, 72 people participated in focus groups/individual interviews (asthma n = 18/n = 21; COPD n = 15/n = 18). “Shortness of breath” was the most frequently reported symptom; however, participants discussed the life impact of their condition more than symptoms alone. Reported physical impacts included the inability to sleep and socialize, while emotional impacts included “embarrassment, stigma, and/or self-consciousness”, “fear and/or panic”, and “sadness, anxiety, and/or depression”. Coping mechanisms for normal activities included continuing at reduced pace and avoidance. Treatment preferences centered on resolving impacts; improved sleep, “speed of action”, and “length of relief” were the most frequently reported ideal treatment factors.ConclusionPatients with asthma or COPD experience substantial quality of life limitations and tend to focus on these in their expressions of concern, rather than symptoms per se. Life impacts of these conditions may have implications beyond those commonly appreciated in routine practice; these considerations will be applied to a future discrete choice experiment survey.FundingGSK funded study (H0-15-15502/204821).Electronic supplementary materialThe online version of this article (doi:10.1007/s12325-017-0557-0) contains supplementary material, which is available to authorized users.
Highlights
The impact of asthma and chronic obstructive pulmonary disease (COPD) on individuals’ lives may be substantial, yet clinical practice often focuses only on symptoms
A semi-structured interview guide was used with prespecified topics, informed by a literature review, that were considered impactful in asthma or COPD
Our series of interviews and focus groups confirmed that when discussing their condition individuals with asthma or COPD have a tendency to focus on life impact, rather than symptoms per se
Summary
The impact of asthma and chronic obstructive pulmonary disease (COPD) on individuals’ lives may be substantial, yet clinical practice often focuses only on symptoms. Asthma and chronic obstructive pulmonary disease (COPD) are two of the most common respiratory conditions in the UK [1, 2]. The measurement and management of symptoms tend to be the primary focus for clinical experts, patients with asthma or COPD are typically more concerned with the overall impact of their condition on their quality of life (QoL) [7, 8]. Clinical measurements (such as lung function) do not always correlate with how individuals feel [9] This is true for patients with asthma, for whom feelings of anxiety and loss of control are common [10, 11]. The irregular nature of asthma exacerbations appears to affect the perception of asthma control, which is typically overestimated by many patients with asthma (based on their ability to manage exacerbations, rather than their frequency of symptoms or exacerbations [12, 13])
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