Questionnaire-based analysis of the current level of asthma control and management in Niigata Prefecture, Japan: Changes from 1998 to 2000

Abstract

It is very important to use antiinflammatory agents, including inhaled corticosteroids, in the management of asthma because bronchial inflammation is a fundamental component of bronchial asthma. Although management according to this strategy is recommended in several countries, the actual situation of asthmatic patients in Japan is poorly understood. To clarify the actual management of asthma in Japan, the present study was undertaken. In 1998, for 8 weeks from September through to October, questionnaires on asthma control and satisfaction in daily life were given to asthmatic patients. In addition, questionnaires regarding patient profiles and medication were given to the patients' physicians. The same questionnaires were repeated in 1999 and 2000. The information obtained from the same patients and their physicians who responded in each of the three years was used for analysis. We analyzed 840 cases. During this period, over 80% of patients used oral theophylline, although the percentage of patients using inhaled steroids and leukotriene receptor antagonists increased from 67.0 and 29.8% in 1998 to 75.1 and 34.2%, respectively, in 2000. Asthma control (including the presence of attacks and self-evaluation by each patient), asthma- related symptoms and sleep disturbance improved significantly. However, there was no improvement in satisfaction in daily life of asthmatic patients surveyed. Multiple-regression analysis revealed that self-evaluation of asthma control by each patient was significantly related to improvement in satisfaction in daily life. These results indicate that antiinflammatory agents, including inhaled corticosteroids and leukotriene receptor antagonists, contributed to improved asthma control, whereas oral theophylline is characteristically used in Niigata Prefecture, Japan. However, not all asthma-related problems, such as satisfaction in daily life, improved and self-evaluation of asthma control by patients may play a key role in improving their satisfaction in daily life.